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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 Publication17-May-2019

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

DOI: 10.4103/2229-5178.258581

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 [Epub ahead of print] [cited 2019 Jun 16]. Available from: http://www.idoj.in/preprintarticle.asp?id=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 Χ 1 Χ 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-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 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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  [Figure 1], [Figure 2], [Figure 3]


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