Hyperpigmented nodule

Abstract: INTRODUCTION: Granular cell tumor, also known as Abrikossoff's tumor, is a rare benign tumor of neural origin, which can arise at any part of the body; however the tongue (30%) is the most commonly affected site. Its clinical behavior is usually benign although malignant and multifocal forms are also known to occur. CASE REPORT: A case of granular cell tumor in a 33 year old female who presented with a firm hyperpigmented nodule on the lateral aspect of the left upper arm. CONCLUSION: This case is quite rare: only a few cases were presented in literature with hyperpigmentation.

Abstract: A 34-year-old Haitian man presented with a 1-year history of a gradually en- larging, ulcerating nodule on the right posterior ankle that bled after trauma. The patient denied any history of prior trauma at the site of the lesion and foreign travel.There were no HIV risk factors or personal or family history of skin cancer.The patient was otherwise healthy with no additional complaints. Physical examination revealed a 1.4 cm firm, hyperpigmented nodule with a yellow crateriform center on the right posterior ankle (Figure 1).A punch biopsy was performed (Figures 2, 3). Histopathologic examination revealed a superficial and mid-dermal, multi- nodular proliferation of bland epithelioid cells with occasional foci of ductal differentiation embedded in a fibrotic stroma. Focal epidermal connection and mucinous metaplasia were noted. Immunohistochemical stains revealed diffuse positive staining of the lesional cells with cytokeratins (high and low) and variable positivity with epithelial membrane antigen (EMA), as well as negative S100P. Fungal, viral, and mycobacterial tissue cultures were negative and RPR was non-reactive. Bacterial tissue culture was positive for Prevotella oris and Staphylococcus aureus.

Abstract: A 7-year-old otherwise healthy African-American girl with no significant medical history presented with a 6month history of a slow-growing, nontender, nonpruritic, firm, hyperpigmented nodule overlying the right Achilles tendon (Fig 1). Stroking of the lesion did not produce any localized skin changes. There were other similar lesions noted on examination. Conjunctival examination and visual acuity were normal. The patient was developmentally normal without any focal neurologic deficits. Axillary and inguinal freckling were absent.

Abstract: DOI: 10.4103/ijd.IJD_603_18 A healthy 33‐year‐old man presented with a depressed, non‐tender soft plaque on his back since 1 year. The lesion measured 0.7 mm in diameter and was hyperpigmented [Figure 1]. There was neither history of previous similar lesion, nor any history of antecedent trauma to this site. Upon skin biopsy and histological examination, storiform fascicles of uniform spindle‐shaped cells with invasion to the subcutaneous fat tissue were seen [Figure 2]. A diagnosis of malignant spindle cell tumor was made from the history, clinical presentation, and pathological study, and excision of the lesion was advised. An immunohistochemical examination for Ki67, a nuclear antigen that reflected proliferation, showed 10%–15% of cells in mitotic phase [Figure 3]. Question What is Your Diagnosis?