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A proliferating pimple
  1. S Puppala1,
  2. V P Muralikrishnan1,
  3. D M Wayte2,
  4. L R Jenkinson
  1. 1Department of General Surgery, Ysbyty Gwynedd, North West Wales NHS Trust, Bangor LL57 2PW, UK
  2. 2Department of Pathology
  1. Correspondence to:
 Mr Jenkinson;
 Lloydjenk{at}doctors.org.uk

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Answers on p 251.

A 63 year old man was referred by the general practitioner with a skin lesion on the right buttock which he had for three months. The lesion started as a small “pimple” and gradually increased in size. It was associated with occasional minor bleeding and pain when touched. There were no other systemic symptoms and no associated past medical history. Physical examination revealed a 5 cm firm erythematous skin nodule with involvement of the subcutaneous tissue as shown in the fig 1A. There was an indurated erythematous “halo” around its base. A biopsy of the lesion was performed and the histology was as shown in the fig 1B.

Figure 1

(A) Erythematous skin nodule and (B) histology of lesion.

QUESTIONS

  1. What is the differential diagnosis on clinical examination?

  2. What does the histology reveal and what histological techniques are used to establish the diagnosis?

  3. Discuss the clinical features and management of this lesion.

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