A Persistent “Pimple” in a 5-Year-Old Girl

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Figures

Figure 1

A 4 mm apricot colored, dome-shaped firm papule with overlying telangiectasias below the nasal columella.

Figure 2

Pink-red rim in a “setting sun” pattern seen by dermoscopy.

Figure 3

Shave biopsy demonstrating a dense infiltrate with multiple giant cells amidst an abundance of lipidized histiocytes and scattered inflammatory aggregates composed of lymphocytes and eosinophils.

A 5-year-old girl presented for evaluation of a slowly enlarging, asymptomatic “pimple” below the nose that appeared 3 months prior to presentation. The child was otherwise healthy, and the mother had a history of thyroid cancer. On physical examination, subjacent to the nasal columella was a 4mm apricot colored, dome-shaped firm papule with overlying telangiectasias (Figure 1). Dermoscopy revealed a conspicuous pink-red rim in a “setting sun” pattern (Figure 2). Given the family history of cancer, the parents were concerned about the possibility of malignancy and elected to proceed with a skin biopsy.

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