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October 2005

Telangiectatic Macule of the Cheek—Diagnosis

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Arch Dermatol. 2005;141(10):1311-1316. doi:10.1001/archderm.141.10.1311-e

The biopsy specimen revealed numerous poorly circumscribed, highly cellular nodules in the upper reticular dermis. The nodules were composed of oval to spindle-shaped cells with eosinophilic cytoplasm and a myoid appearance. Most of the nodules displayed apparent concentric perivascular growth; however, lesional cells were also identified in the perilesional stroma. Nuclear pleomorphism was evident and mitotic figures were identified in most of the high-power fields that were examined. Immunohistochemical analysis showed that the proliferative cells were positive for smooth muscle actin but negative for CD31, CD34, desmin, and S100 protein. These histologic findings were most consistent with malignant myopericytoma. The patient underwent wide local excision and was still without clinical evidence of disease after approximately 16 months of follow-up.

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