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Special Feature
October 05, 2009

Picture of the Month—Quiz Case

Author Affiliations



Copyright 2009 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2009

Arch Pediatr Adolesc Med. 2009;163(10):955. doi:10.1001/archpediatrics.2009.163-a

A previously healthy 14-year-old girl had a large but asymptomatic lesion on the left lower eyelid margin (Figure 1A). She had first noted a small papule that gradually and progressively grew over 5 months. She also noticed that the lesion had grown after minor trauma. On physical examination, the lower eyelid lesion was a firm, pink, 28 × 19 × 15-mm nodule with central ulceration and crust. The remainder of the skin examination results were normal.

Figure 1.
Image not available

Nodules involving eyelids. A, Patient 1, a 14-year-old girl, with a large ulcerated nodule involving the left lower eyelid. B, Patient 2, a 10-year-old boy, with an inflamed nodule involving the left upper eyelid.

An otherwise healthy 10-year-old boy had a large and growing asymptomatic lesion on the left upper eyelid (Figure 1B). He had noted a small, bluish papule 2 months previously; the lesion had grown following trauma when he was hit in the ipsilateral eye by a dodgeball. On physical examination, the upper eyelid lesion was a firm, pink, 25 × 12 × 6-mm nodule with overlying telangiectasias. He had smaller but similar-appearing lesions on his right foot and left upper arm. The remainder of the skin examination results were normal.

What is your diagnosis?