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January 1987

Umbilical Nodule and Abdominal Pain

Author Affiliations

The University of Rochester (NY) School of Medicine and Dentistry

Arch Dermatol. 1987;123(1):107-108. doi:10.1001/archderm.1987.01660250113032

REPORT OF A CASE  A 42-year-old congenitally deaf woman was referred for evaluation of abdominal pain of one year's duration. This pain was relieved by antacids and was separate from the vague lower abdominal discomfort that occurred at irregular intervals. The pain was periumbilical, nonradiating, unrelated to her menses, not relieved by antacids, and only mildly relieved by aspirin. Extensive blood and roentgenographic studies revealed only a hiatal hernia. She was referred to dermatology because of the papule noted in her umbilicus (Fig 1). Although it had bled once several months before, this papule had otherwise gone unnoticed. The papule was brown-blue, with a nodular surface and slight scale. It occupied the lower third of the umbilical depression and was tender to palpation.Physical examination revealed some mild tenderness in both lower quadrants, the mammillated papule in the umbilicus resembling a seborrheic keratosis, her near total deafness, and no