A young man with multiple reddish papules and nodules on the trunk and extremities

A 23-year old man was presented with multiple papules and nodules (25 lesions) on the trunk and proximal extremities (figure 1). two or three lesions were appeared at childhood and increased to 25 lesions in early adulthood. there were variations in size from several millimeters to 2 cm with spontaneous and inducible pain especially in exposure to the cold environment. same lesions were present in his brother, aunt and uncle. we performed biopsy from one of the lesions on the trunk.