Acquired hyperpigmented tumor in a teenager

Abstract

A 13-year-old female with Crouzon syndrome and hydrosyringomyelia was referred for assessment of a tumor located on her back adjacent to the right scapula. The lesion had appeared 2 months previously.The mother reported that the tumor developed on top of a congenital macule. The lesion was reported to have exophytic growth, was asymptomatic, and did not bleed.Physical examination revealed a sessile, firm, and dark blue-purple tumor with well-defined borders, a lobulated surface, and a depressed center, measuring 1 Â 0.5 cm (Figure 1); there was no macule visible under the tumor. Dermoscopy showed blue-gray ovoid nests with bright whitish areas (chrysalis) and a central depression with small crusts (Figure 2). An excisional biopsy was performed (Figures 3 and 4).