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SKINDIA QUIZ
Year : 2019  |  Volume : 10  |  Issue : 4  |  Page : 488-489  

SkIndia Quiz 52: A verrucous growth over elbow of a young child


Department of Dermatology, Venereology and Leprology, R.N.T. Medical College, Udaipur, Rajasthan, India

Date of Web Publication28-Jun-2019

Correspondence Address:
Asit Mittal
Department of Dermatology, Venereology and Leprology, R.N.T. Medical College, Udaipur -313 001, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.258581

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How to cite this article:
Beniwal R, Mittal A, Gupta K, Balai M. SkIndia Quiz 52: A verrucous growth over elbow of a young child. Indian Dermatol Online J 2019;10:488-9

How to cite this URL:
Beniwal R, Mittal A, Gupta K, Balai M. SkIndia Quiz 52: A verrucous growth over elbow of a young child. Indian Dermatol Online J [serial online] 2019 [cited 2019 Jul 21];10:488-9. Available from: http://www.idoj.in/text.asp?2019/10/4/488/258581



A 6-year-old male child presented to us with a single, asymptomatic, verrucous lesion over right elbow since 6 months. The lesion was initially small and slowly progressed with time to attain the present dimensions. Apart from a history of occasional bleeding after minor trauma, there were no other complaints. Physical examination revealed a solitary, slightly scaly, erythematous, verrucous nodule of about 1 × 1 × 1 cm in size over right elbow. The nodule was firm in consistency on palpation and did not elicit any tenderness [Figure 1]. The child was in good general health. A biopsy was taken from the lesion.
Figure 1: Solitary, erythematous, verrucous nodule over elbow

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   Question Top


What is your diagnosis?

Histology showed moderate epidermal hyperplasia with focal hypergranulosis [Figure 2]a, [Figure 2]b, [Figure 2]c, [Figure 2]d. Several vertically oriented small and medium sized nests of epithelioid melanocytes were seen at dermo-epidermal junction. The entire dermis was infiltrated by nests and small cords of spindled and epithelioid melanocytes with a sparse to moderately dense lymphocytic infiltrate. Immunohistochemistry showed positivity for S100 and Melan A [Figure 3]a and [Figure 3]b.
Figure 2: (a-d) Histology showing vertically oriented nests of spindled and epithelioid melanocytes in the dermis (H and E stain ×2.5, ×5, ×10, and ×20)

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Figure 3: (a and b) Immunohistochemistry showing S100 (×10) and Melan A positivity (×10)

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   References Top

1.
Yoradjian A, Enokihara MM, Paschoal FM. Spitz nevus and Reed nevus. An Bras Dermatol 2012;87:349-59.  Back to cited text no. 1
    
2.
Lyon VB. The spitz nevus: Review and update. Clin Plast Surg 2010;37:21-33.  Back to cited text no. 2
    
3.
Chen J, Kong QT, Zhang M, Sang H. Recurrent Spitz nevus with multiple satellite lesions on perineum. Indian J Dermatol Venereol Leprol 2015;81:96.  Back to cited text no. 3
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4.
Honda R, Iino Y, Ito S, Tanaka M. Verrucous spitz nevus in a Japanese female. Case Rep Dermatol 2013;5:304-8.  Back to cited text no. 4
    


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  [Figure 1], [Figure 2], [Figure 3]



 

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