History:

 Rough scaly papules on the neck especially if in an annular configuration should make you think of elastosis perforans serpiginosa. The condition is usually seen in young males around their late teens, is genetic in some cases, may be associated with Down's syndrome and osteogenesis imperfecta and some other syndromes and may be due to penicillamine. It often presents as an annular , linear or serpiginous scaly rash on the side of the neck.

Histology shows a perforating picture with elastic tissue extruding through the epidermis.

You can look at a review of the condition here.