Introduction
Cardiofaciocutaneous (CFC) syndrome is a rare autosomal dominant inherited disorder, though it can also manifest as a de novo mutation in a family without a history of a similar condition (1). The syndrome was first described by Reynolds et al. in 1986 (2). It results from a mutation in genes encoding the rat sarcoma (RAS)/mitogen-activated protein kinase (MAPK) signaling pathway and is known as one of the RASopathies (3). The most common mutations in Cardiofaciocutaneous (CFC) syndrome , including BRAF, MAP2K1 and MAP2K2, or rarely KRAS genes. Multiple organs can be involved, manifesting with distinctive facial features, cardiac abnormalities, neuromotor delay, intellectual disability, and ectodermal abnormalities (4). The phenotypic features overlap with other RASopathies, especially Noonan syndrome and Costello syndrome (5). Ulerythema ophryogenes also known as Keratosis pilaris rubra atrophicans faciei, is a rare dermatological disorder of keratinization .the etiology is still unclear although it has been associated with several congenital anomalies such as cardiofaciocutaneous (CFC) syndrome ,Noonan syndrome, Cornelia De Lange syndrome and Rubinstein-Taybi syndrome. and It manifests with perifollicular erythema and multiple inflammatory keratotic facial papules, which my result in alopecia ,scars and atrophy(6).