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September 1997

Periorbital Solitary Nodule and Multiple Small Papules in a 63-Year-Old Woman

Author Affiliations

University of Colorado Health Sciences Center, Denver

Arch Dermatol. 1997;133(9):1161-1162. doi:10.1001/archderm.1997.03890450111015

REPORT OF A CASE  A 63-year-old woman presented to the dermatology clinic with a 6-mm, tender, firm nodule just lateral to her left eye (Figure 1). She reported slow growth of the lesion over the past 6 months. The nodule was clinically consistent with an epidermoid cyst. The findings of the rest of the physical examination were unremarkable, and the nodule was excised. Histologic examination showed abundant mucinous material in the reticular dermis, associated with clusters of cells with a high nuclear-cytoplasmic ratio, hyperchromatic nuclei, and eosinophilic cytoplasm (Figure 2). At a follow-up examination 1 month later, the patient reported the sudden occurrence of several small facial lesions. Physical examination revealed multiple, nontender, flesh-colored papules under both eyes, as well as a new nodule at the site of the previous biopsy (Figure 3). A biopsy specimen taken from the left periorbital lesion again showed lakes of mucin containing islands of