A red nodule on the tip of the nose in a Chinese girlA 7-year-old girl presented with a red nodule on the apex of the nose for 1 month without any other symptom. Skin examination revealed a well-defined, round, pink nodule measuring 1.2 × 1.5 cm with a hard texture [Figure 1a]. Her past medical history was unremarkable.An incisional biopsy showed normal epidermis and nests or sheets of small round cells with atypical nuclei and scanty cytoplasm in the reticular dermis. The tumor cells formed alveolar structures. Necrosis, cross striations or obvious mitotic activity were absent [Figures 1b and c]. Immunohistochemical studies demonstrated that the tumor cells were strongly positive for vimentin, myoblast determination protein 1, desmin and myogenin, weakly positive for myoglobin (focal), synaptophysin, cytokeratin and Ki-67 (30% +); and negative for S-100, smooth muscle actin and cluster of differentiation (CD) 3 [Figures 2a-d].