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JAMA Pediatrics Clinical Challenge
May 2014

Boy With Yellow-Orange, Rough Nodule on Right Thigh

Author Affiliations
  • 1Rush Medical College, Chicago, Illinois
  • 2Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota
  • 3Department of Diagnostic Radiology, Mayo Clinic, Rochester, Minnesota
  • 4Division of Pediatric Dermatology, Mayo Clinic, Rochester, Minnesota
JAMA Pediatr. 2014;168(5):493-494. doi:10.1001/jamapediatrics.2013.3979

An 8-year-old otherwise healthy boy presented with a yellow-orange, rough nodule on his medial right thigh (Figure 1). It had evolved from a flat discoloration since the age of 3 years, which continued to slowly enlarge and thicken. The patient denied spontaneous bleeding or ulceration, and he had full range of motion and use of his extremity. Neither he nor his family members reported a history of similar lesions on their body. He did not take any medications, had never been hospitalized, and had never had any major surgical procedures. His upper and lower extremities were otherwise normal. On inspection, there was a 4.5 cm × 3.5 cm, verrucous plaque with underlying fullness on the right medial thigh. There were also punctate vessels evident on the hyperkeratotic surface.

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