A Patient from Ghana - Please comment

Anak VGRD members have been asked to comment on a 16 year old Ghanaian girl from a small village without any specialized medical care. In otherwise good health and of normal intelligence, since age two she has a history of small hyperpigmented papules on her face. The larger lesions on her forehead appeared over the last two years. She patient states that she doesn't manipulate any of the lesions and that they are asymptomatic. There has been no treatment. HIV status and family history are unknown. This unfortunate young woman feels like an outcast because of these lesions.

We welcome you thoughts and advice. There are medical students in her community who could perhaps perform diagnostic testing if needed.