A 10-year-old Caucasian female with Goltz syndrome (GS) was referred for management of ocular papillomas (Fig. 1A). She was born full-term with multiple congenital dysmorphisms, including syndactyly (Fig. 1B), ear anomalies, hearing loss, generalized vesicular rash, atrial septal defect, and developmental delay. GS was diagnosed clinically and confirmed genetically; parental genetic testing was negative. Surgical history included bilateral myringotomies, tonsillectomy and adenoidectomy for obstructive sleep apnea (OSA), right toe amputation, and multiple papilloma excisions (axilla, ears, and lips).