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July 2006

Atrophic Congenital Lesion on the Back—Quiz Case

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Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2006

Arch Dermatol. 2006;142(7):921-926. doi:10.1001/archderm.142.7.921-c

A 2-month-old girl presented with a cutaneous lesion on her left scapular area that had been present since birth. Her medical family history was unremarkable. She was born via vaginal delivery after 39 weeks of normal pregnancy. No forceps were necessary. Her Apgar score was 9/10 and she weighed 2900 g. She did not require monitoring, and no electrode leads or adhesive devices were used.

On physical examination, a 6 × 4-cm bluish-brown oval depression with a well-defined contour was evident on the left scapular area (Figure 1). There was thin hair on the surface, and the underlying blood vessels were visible. No induration was noted on palpation, but there was loss of substance, and the atrophic skin wrinkled easily. The lesion had been enlarging proportionately as the girl grew. Physical examination revealed no other lesions or associated defects. An echographic study of the lesion demonstrated no muscular alteration. A cutaneous biopsy was performed (Figure 2 and Figure 3).