A 4 month-old otherwise healthy boy presented with a cluster of pink-brown, soft papules on the left auricle; apparently asymptomatic and present for a month. There was no remarkable family history for neurocutaneous disorders, seizures, or endocrine abnormalities. My clinical differential was that of agminated Spitz nevi, doubtful xanthogranulomas, lymphocytic infiltrate, or granuloma annulare. A biopsy revealed an angiofibroma. A subsequent full cutaneous and Wood’s light examination was unremarkable – no hypopigmented macules, Shagreen patches, etc were noted. The only other time I have seen auricular angiofibromas was in a patient with NF type 2 (Jaffe AT, Heymann WR, Schnur RE. Clustered angiofibromas on the ear with a patient with neurofibromatosis type 2. Arch Dermatol 1998; 134: 760-1.). Although I think his prognosis is excellent, I asked that he see pediatric ophthalmology, genetics, and audiology. The parents gave me permission to show his image – please let me know if you have any other diagnostic considerations or work-up recommendations. Thank you!