Firm, protuberant plaque on a 7‐year‐old's arm

Abstract

A 7-year-old girl with no relevant past medical history presented with a several-month history of an expanding, darkening lesion on the left arm. She reported occasional tenderness but no itching, drainage, or bleeding. Examination revealed a 1.5-by 1.2-cm, hyperpigmented, firm, protuberant, nonscaly plaque on the proximal side of the left arm (Figure 1).Excisional biopsy with 1-mm margins was performed and submitted for histologic evaluation (Figures 2 and 3).