Presenter: Suleman Bangash, Chief Resident and Carissa Summa, Second Year Resident
Dermatology Program: New York United Medical Center, New York
Program Director: Cindy Hoffman, DO, FAOCD
Submitted on: Jan 1, 2005
CHIEF COMPLAINT: Growth on the Left Foot
Signs and symptoms: Lesion was slightly tender to palpation
Previous Treatment: None
Other information: The patient had a past medical history significant for Milroy’s disease (Congenital Lymphedema). She reported that the lesion began as a brown patch and slowly enlarged to a dome-shaped nodule over several years. She also reported multiple similar, but smaller lesions on her upper and lower extremities and trunk. The patient was only taking Hydrochlorothiazide for the lower extremity edema.
A 3.0 X 3.2 cm, slightly hyperpigmented, soft, pedunculated nodule was present on the left dorsal foot. A total of nine hyperpigmented, firm 0.5 – 1.0 cm nodules were found on bilateral upper and lower extremities and trunk.
A shave biopsy of the left dorsal foot lesion was done.
Microscopic description: Spindle cell tumor composed of fibroblasts, histiocytes, and multinucleated giant cells in the dermis. The overlying epidermis is hyperplastic with elongation of rete ridges.
1. Polypoid nodular dermatofibroma
2. Superficial leiomyoma
5. Acquired Fibrokeratoma