Department of Dermatology, Tokyo Medical and Dental University School of Medicine, Japan.
A 58-year-old male presented multiple papules on the nose for over 10 years. Excisional biopsy revealed angiofibroma with perivascular fibrosis and coarse collagen fibers. Investigation for internal malignancies revealed gastric cancer. Messenger RNA for HER-2/neu and c-ras were found both in the lesions of the skin and stomach. We propose the term, fibropapule multiplex of the nose, which may be a variant of Cowden's disease associated with occult internal malignancy.