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October 1995

Enlarging Nodules on the Toe of an Infant

Author Affiliations

University of North Carolina at Chapel Hill School of Medicine

Arch Dermatol. 1995;131(10):1195-1196. doi:10.1001/archderm.1995.01690220101018

REPORT OF A CASE  A 10-month-old white boy presented with enlarging exophytic, asymptomatic nodules on the third toe of the left foot. The child was the 1000-g product of a 28-week twin pregnancy. The history was notable for multiple complications of prematurity, including chronic lung disease, intracranial hemorrhage, hydrocephalus, and developmental delay. The twin brother had a more benign neonatal course, fewer problems of prematurity, was developing normally, and had no nodular skin lesions.Physical examination revealed 7- to 8-mm, firm, smooth, shiny, flesh-colored to purplish nodules on each of the lateral aspects of the left third toe (Figure 1). A 1- to 2-mm papule was evident proximal to the nodule located on the medial side of the toe. The skin examination was otherwise unremarkable. A punch biopsy specimen was obtained from one of the distal toe nodules. Tissue was stained with hematoxylin-eosin (Figure 2 and Figure 3) and phosphotungstic

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