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Leslie Castelo-Soccio, MD, PhD; William R. Katowitz, MD; James A. Katowitz, MD; Kara N. Shah, MD, PhD; James R. Treat, MD; Albert C. Yan, MD

Arch Pediatr Adolesc Med. 2009;163(10):955. doi:10.1001/archpediatrics.2009.163-a

A previously healthy 14-year-old girl had a large but asymptomatic lesion on the left lower eyelid margin (Figure 1A). She had first noted a small papule that gradually and progressively grew over 5 months. She also noticed that the lesion had grown after minor trauma. On physical examination, the lower eyelid lesion was a firm, pink, 28 x 19 x 15-mm nodule with central ulceration and crust. The remainder of the skin examination results were normal.

View larger version (158K): [in this window] [in a new window] [as a PowerPoint slide]   Figure 1. Nodules involving eyelids. A, Patient 1, a 14-year-old girl, with a large ulcerated nodule involving the left lower eyelid. B, Patient 2, a 10-year-old boy, with an inflamed nodule involving the left upper eyelid.

An otherwise healthy 10-year-old boy had a large and growing asymptomatic lesion on the left upper eyelid (Figure 1B). He had noted a small, bluish papule 2 months previously; the lesion had grown following trauma when he was hit in the ipsilateral eye by a dodgeball. On physical examination, the upper eyelid lesion was a firm, pink, 25 x 12 x 6-mm nodule with overlying telangiectasias. He had smaller but similar-appearing lesions on his right foot and left upper arm. The remainder of the skin examination results were normal.

What is your diagnosis?

Author Affiliations: Section of Dermatology (Drs Castelo-Soccio, Shah, Treat, and Yan) and Division of Ophthalmology (Drs W. R. Katowitz and J. A. Katowitz), Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia.

SECTION EDITOR: SAMIR S. SHAH, MD, MSCE

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Arch Pediatr Adolesc Med. 2009;163(10):956.
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