Presenter: Francisca Valenzuela, MD, Thomas L Davis, MD, Michael Hohnadel, DO
Dermatology Program: South Texas Dermatology Residency, HCA Healthcare Corpus Christi Medical Center – Bay Area Program
Program Director: Rick Lin, DO MPH FAOCD
Submitted on: June 14, 2023
CHIEF COMPLAINT: “I have persistent growths on my back around a prior surgical scar”
CLINICAL HISTORY:
Signs and symptoms: A 23-year-old male with no significant past medical history presented to our clinic with multiple grouped lesions on his back surrounding a previous scar. The patient and his parents reported that he has had these spots since childhood, though they could not confirm whether he was born with them. They also did not remember the specific surgical procedure that created the scar during his childhood. The patient was worried about the spots, as they had recently begun to bleed. He denied any personal or family history of skin cancer.
PHYSICAL EXAM:
On physical examination, the patient exhibited multiple grouped pink, translucent, and hemorrhagic thick-walled vesicles, resembling “frog spawn.” The vesicles were firm to palpation and remained intact without any signs of rupture.
LABORATORY TESTS:
N/A
DERMATOHISTOPATHOLOGY:
Histopathologic studies revealed dilated spaces filled with lymphatic fluid within the papillary dermis, along with the presence of erythrocytes in the lumen. The overlying epidermis was noted to be thinned and raised.
DIFFERENTIAL DIAGNOSIS:
-
- Epidermal nevus
- Lymphangioma circumscriptum
- Molluscum contagiosum
- Allergic contact dermatitis
- Herpes simplex virus
- Herpes Zoster
- Dermatitis Herpetiformis
- Dabska tumor
- Stewart-Treves syndrome
- Lymphangiectasia