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Off-Center Fold
November 2002

Nodule on the Shoulder of a Young Woman

Author Affiliations
 

MICHAEL E.MINGMD

Arch Dermatol. 2002;138(11):1509. doi:10.1001/archderm.138.11.1509

A 36-year-old white woman presented with a 5-month history of an irritating lesion on her left shoulder. A crusted scab had arisen and fallen off, leaving her with a 1.5-cm, smooth, tender, intradermal nodule with no obvious surface abnormality (Figure 1).

The differential diagnosis included a keloid scar, adnexal tumor, and amelanotic melanoma. A biopsy specimen from the center of the lesion was obtained for histologic (Figure 2) and immunohistochemical staining with α-smooth muscle actin (Figure 3). The nodule remained exquisitely tender, and a complete excision was performed.

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