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March 2009

A Solitary Nodule on the Finger—Diagnosis

Author Affiliations

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

Arch Dermatol. 2009;145(3):321-326. doi:10.1001/archdermatol.2008.625-b

Histopathologic examination of the biopsy specimen revealed an acanthotic epidermis with delicate fingerlike projections extending into the dermis, marked spongiosis, and ballooning degeneration with associated epidermal necrosis. Also, there were prominent intracytoplasmic eosinophilic inclusion bodies within the keratinocytes, which were undergoing ballooning degeneration. The underlying dermis demonstrated marked edema, with dilated blood vessels, extravasated erythrocytes, and a mixed inflammatory infiltrate that was composed of lymphocytes and scattered neutrophils. No intervention was undertaken, and over the next month, the lesion became less elevated and developed an overlying dry crust before undergoing total involution. No recurrence was observed over the next several months.