A 65-year-old man with a 10-year history of type II diabetes mellitus (DM), hypertension, and chronic renal failure (glomerular filtration rate of 36 ml/min/1.73 m2) presented with a 3-month history of mildly pruritic erythematous papules and nodules located on the anterior and lateral aspects of both thighs, some of them with a linear arrangement. Central keratotic plugs were evident within the lesions and were easily removed with gentle manipulation (figure 1). A skin biopsy was performed, and histopathological examination with haematoxylin and eosin staining demonstrated dilated follicular infundibula filled with keratinous and cellular debris. The follicular epithelium was disrupted in at least one area and the adjacent dermis showed degenerative changes. A moderate perivascular inflammatory infiltrate was present.