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March 2007

A Nodule on a Boy’s Back—Quiz Case

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Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Dermatol. 2007;143(3):417-422. doi:10.1001/archderm.143.3.417-a

An 11-year-old boy presented with a 3-month history of a slow-growing asymptomatic nodule on his back. His adoptive mother reported that the lesion, which was initially thought to be an insect bite, did not respond to treatment with topical steroids or antibiotics. The patient had been adopted from the Ukraine Republic when he was 5 years old. Since the adoption, his medical history had been unremarkable and he was otherwise healthy. Physical examination showed a 3-cm reddish purple nodular lesion surrounded by a whitish halo in the right scapular region (Figure 1). There was no adenopathy or other skin lesions. A cutaneous punch biopsy specimen was obtained from the erythematous portion of the lesion (Figure 2 and Figure 3).

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