History: This patient presented with a pinkish nodule on the right shoulder of many months duration. The lesion was asymptomatic, seemed to be hollow on palpation with positive button hole sign. He has no associated systemic disease or a primary skin disease in the affected area prior to the appearance of the lesion. Anetoderma is characterized by localized loss of elastic tissue resulting in herniation of subcutaneous tissue. The lesions protrude from the skin,and on palpation have less resistance than the surrounding skin, producing the "button hole" sign identical to a neurofibroma. The surface skin may be slightly shiny, white, and crinkly. The usual sites are the trunk, especially on the shoulders, upper arms, and thighs.