Rapidly growing hemorrhagic papule on the cheek of a 54-year-old man

Junck, Marianne; Huerter, Christopher J.; Sarma, Deba P.

doi:10.5070/d34fz1k3pt

Cited by 3 publications

(4 citation statements)

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“…PG is a benign vascular lesion that usually occurs in the skin or mucous membranes [ 1–5 ]. Most theories suggest that PG is a proliferative response of capillaries to an angiogenic stimulus such as trauma, this theory is similar to our case as this patient suffer from trauma to his thumb [ 1 , 4 , 6 ]. Giblin et al .…”

Section: Discussionsupporting

confidence: 84%

“…It affects both genders and all ages with more tendency towards males and children. Most theories suggest that PG is a hyperplastic, neovascular response to stimulus such as infections, trauma, medications such as retinoids, and hormonal factors [ 1 , 4 , 6 ]. Histological examination revealed capillary proliferation with stromal edema and a mixed inflammatory infiltrate [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Pyogenic granuloma of the thumb mimicking squamous cell carcinoma of the nail subunit: case report and review of the literature

Alkabbaa

Alsaedan

Alammar

2023

Journal of Surgical Case Reports

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Pyogenic granuloma (PG) is a benign vascular lesion that usually occurs in the skin or mucous membranes. Multiple theories have been implicated in its aetiology. It can mimic variable malignancies in which histopathological examination plays a vital role. We report a case of PG of the left thumb nail subunit in a 40-year-old gentleman, who presented with left thumb mass after a trauma by a wooden splinter. Incisional biopsy of the lesion could not rule out squamous cell carcinoma. Therefore, full radiological studies were carried out as part of this highly suspicious lesion’s work-up. Excisional biopsy was performed and a full thickness skin graft was harvested from the left distal forearm and applied to cover the defect. Final histopathological examination revealed the diagnosis of PG. The wound subsequently healed well with good functional and aesthetic outcome.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Pyogenic granuloma of the thumb mimicking squamous cell carcinoma of the nail subunit: case report and review of the literature

Alkabbaa

Alsaedan

Alammar

2023

Journal of Surgical Case Reports

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“…In total, 62 articles were included in this systematic review, reporting on 433 melanoma cases. Of these articles, 30 reported on amelanotic melanoma (275 cases), 6 on animal-type or pigmented epithelioid melanocytoma (PEM) (7 cases), 4 on balloon cell melanoma (5 cases), 4 on desmoplastic melanoma (66 cases), 1 on follicular melanoma (1 case), 4 on nested melanoma (6 cases), 5 on nevoid melanoma (31 cases), 1 on primary dermal melanoma (1 case), 3 on spitzoid melanoma (28 cases), and 4 on verrucous melanoma (4 cases) . One study reported both amelanotic and spitzoid melanoma cases .…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the superficial spreading melanoma (SSM) variant, only a few cases appear to be completely amelanotic on clinical and dermoscopic examination. By systematically searching the literature, we identified 30 studies reporting the clinical and dermoscopic features of 275 amelanotic SSMs . We found 8 additional amelanotic cases from our database, for a total of 283 SSMs.…”

Section: Resultsmentioning

confidence: 99%

Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

et al. 2020

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The clinical and dermoscopic features of the vast majority of uncommon variants of cutaneous melanoma have been rarely reported, leading to difficulty in making accurate diagnoses.OBJECTIVE To define the main clinical and dermoscopic features of the most frequently reported but uncommon histologic variants of cutaneous melanoma.EVIDENCE REVIEW A 2-step systematic review of the literature was performed (from inception to November 2018) using PubMed, Embase, and Cochrane Central Register of Controlled Trials databases. The first step identified those uncommon variants of melanoma for which at least 1 case reporting dermoscopy was described in the literature. The keywords searched were melanoma, uncommon, rare, dermoscopy, and dermatoscopy. In the second step, each previously identified uncommon variant was searched for in the same databases by combining the following terms with melanoma, dermoscopy, and dermatoscopy: amelanotic, hypopigmented, animal, melanocytoma, balloon, desmoplastic, follicular, nested, nevoid, dermal, spitz*, spindle, and verrucous. The institution's database was also searched from January 2012 to September 2019 for histopathologically confirmed cases of the same melanoma variants. Each reviewer also assessed the quality of reporting in the included articles based on previously described guidelines.FINDINGS In total, 62 articles met the inclusion criteria, reporting 433 melanoma cases. An additional 56 cases of uncommon melanoma variants were retrieved from the institution's database for a total of 489 cases: 283 cases of amelanotic superficial spreading melanoma, 18 cases of animal-type and pigmented epithelioid melanocytoma, 7 cases of balloon cell melanoma, 71 cases of desmoplastic melanoma, 3 cases of follicular melanoma, 10 cases of nested melanoma, 33 cases of nevoid melanoma, 2 cases of primary dermal melanoma, 57 cases of spitzoid melanoma, and 5 cases of verrucous melanoma. These variants of melanoma occurred more frequently in women than men (147 cases vs 132 cases). Clinically, these tumors were mainly palpable (162 of 217 [74.7%]) or amelanotic (283 of 489 [57.9%]) lesions that could resemble other benign or malignant skin conditions; dermoscopy typically revealed a homogeneous pinkish background, white structures, and polymorphic vessels. The mean age of all included was 58 years (range, 1-89 years).CONCLUSIONS AND RELEVANCE Uncommon melanoma variants may resemble both inflammatory disorders and other cutaneous neoplasms, representing a diagnostic pitfall even for the most experienced dermatologist. The purpose of this systematic review was to provide an extensive and detailed overview of specific clinical and dermoscopic features of each uncommon melanoma variant, highlighting the main criteria for differentiating these variants from other benign or malignant skin lesions.

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Dermoscopic Evaluation of Nodular Melanoma

Menzies¹,

Moloney²,

Byth³

et al. 2013

JAMA Dermatol

106

104

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Importance: Nodular melanoma (NM) is a rapidly progressing potentially lethal skin tumor for which early diagnosis is critical.Objective: To determine the dermoscopy features of NM.Design: Eighty-three cases of NM, 134 of invasive non-NM, 115 of nodular benign melanocytic tumors, and 135 of nodular nonmelanocytic tumors were scored for dermoscopy features using modified and previously described methods. Lesions were separated into amelanotic/ hypomelanotic or pigmented to assess outcomes.Setting: Predominantly hospital-based clinics from 5 continents.Main Outcome Measures: Sensitivity, specificity, and odds ratios for features/models for the diagnosis of melanoma.Results: Nodular melanoma occurred more frequently as amelanotic/hypomelanotic (37.3%) than did invasive non-NM (7.5%). Pigmented NM had a more frequent (compared with invasive non-NM; in descending order of odds ratio) symmetrical pigmentation pattern (5.8% vs 0.8%), large-diameter vessels, areas of homogeneous blue pigmentation, symmetrical shape, predominant peripheral vessels, blue-white veil, pink color, black color, and milky red/pink areas. Pigmented NM less frequently displayed an atypical broadened network, pigment network or pseudonetwork, multiple blue-gray dots, scarlike depigmentation, irregularly distributed and sized brown dots and globules, tan color, irregularly shaped depigmentation, and irregularly distributed and sized dots and globules of any color. The most important positive correlating features of pigmented NM vs nodular nonmelanoma were peripheral black dots/globules, multiple brown dots, irregular black dots/globules, bluewhite veil, homogeneous blue pigmentation, 5 to 6 colors, and black color. A model to classify a lesion as melanocytic gave a high sensitivity (Ͼ98.0%) for both nodular pigmented and nonnodular pigmented melanoma but a lower sensitivity for amelanotic/hypomelanotic NM (84%). A method for diagnosing amelanotic/hypomelanotic malignant lesions (including basal cell carcinoma) gave a 93% sensitivity and 70% specificity for NM.Conclusions and Relevance: When a progressively growing, symmetrically patterned melanocytic nodule is identified, NM needs to be excluded.

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Rapidly growing hemorrhagic papule on the cheek of a 54-year-old man

Cited by 3 publications

References 0 publications

Pyogenic granuloma of the thumb mimicking squamous cell carcinoma of the nail subunit: case report and review of the literature

Pyogenic granuloma of the thumb mimicking squamous cell carcinoma of the nail subunit: case report and review of the literature

Clinical and Dermoscopic Features Associated With Difficult-to-Recognize Variants of Cutaneous Melanoma

Dermoscopic Evaluation of Nodular Melanoma

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