A 6-year-old Chinese girl presented with a 2-month history of an asymptomatic nodule on her left palm. Her medical history was significant for Graves disease, which had been diagnosed 6 months earlier, when she presented with symptoms of thyrotoxicosis and a diffuse goiter. Carbimazole and propranolol hydrochloride therapy was subsequently initiated.
Physical examination revealed a soft, irregularly shaped, skin-colored nodule, measuring 2 cm in diameter, on the left palm (Figure 1). There were no lesions elsewhere, and the patient's thyroid function was normal. A punch biopsy specimen was obtained from the lesion and stained with hematoxylin-eosin (Figure 2).
Tay Y, Ong B. Palmar Nodule in a Child—Quiz Case. Arch Dermatol. 2004;140(1):121-126. doi:10.1001/archderm.140.1.121-c