Presenter: Jonathan Cleaver D.O., Peter Knabel D.O
Dermatology Program: Northeast Regional Medical Center
Program Director: Lloyd Cleaver D.O
Submitted on: Jun 5, 2011
CHIEF COMPLAINT: Soft asymptomatic lesion on the upper mid back.
Signs and symptoms: A 16 year-old well developed female presents to the clinic for evaluation of a lesion on her back that has been present since she was an infant. The lesion has continued to increase in size as she has developed. The lesion is asymptomatic and the patient denies tenderness, drainage, bleeding, or color change. No one else in the family has a similar lesion. She has been healthy since birth and there is no significant family medical history reported. The patient is on no medication.
Previous Treatment: The lesion has been manipulated by the mother multiple times trying to express material from the lesion. She has been unsuccessful at these attempts.
A well-defined 3cm x 1.5cm flesh colored papillomatous plaque on the upper mid back. There were few surface comedones scattered throughout the lesion. The lesion had a soft rubbery consistency and was not fixed to deeper structures.
Histological examination demonstrated slight papillomatosis as well as borderline basal layer pigmentation. The underlying dermis shows the usual fibrocollagenous tissue. Mature adipose tissue is present within the dermis between collagen bundles. No spindle cell lesion or prominent inflammation is identified.
1. Plexiform Neurofibroma
2. Connective Tissue Nevus
3. Penduculated lipofibromas
4. Nevus lipomatosus superficialis
5. Focal dermal hypoplasia