Enlarging Skin Lesion Since Birth

Presenter: Dr. Suzanne Sirota Rozenberg, PGY3, Dr. Norma Montiel, PGY2
Dermatology Program: St. Johns Episcopal Hospital, South Shore, Far Rockaway, New York
Program Director: Marvin Watsky, D.O.
Submitted on: Sep 1, 2004

CHIEF COMPLAINT:  1 month old female presents with an enlarging skin lesion since birth of the right forearm, wrist and hand.

CLINICAL HISTORY:

Signs and symptoms:  The mother states that the lesion has been present since the baby was born and has been getting bigger. The child demonstrates full range of motion of the arm, no crying,crankiness or failure to thrive.

Previous Treatment:  none

Other information:  the patient was born premature at 35 weeks and demonstrated no postnatal complications

PHYSICAL EXAM:

On physical, an erythematous and violaceous papule extending from the forearm to the wrist to the hand and thumb was noted. Easy compressability and blanching were present. No ulcerations or active bleeding were noted. Wrist circumference of the right was 10 ½ cm and the left was 10cm. forearm to the wrist 9 cm on the right and 9 ½ cm on the left. Pt was noted to have a sacral dimple and overlying Mongolian spot as well

 

 

LABORATORY TESTS:

Ultrasound of the lumbosacral spine was unremarkable.

Head CT was also unremarkable.

Genetic testing showed a normal 46 XX karyotype.

All other tests at birth were normal.

DERMATOHISTOPATHOLOGY:

No biopsy was done on this baby.

DIFFERENTIAL DIAGNOSIS:

1.   infantile hemangioma
2.   vascular malformation
3.   Kasabach-Merritt syndrome
4.   angioma
5.   Klippel- Trenaunay syndrome


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