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Skin Lesions

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The Pediatric Upper Extremity

Abstract

Benign skin lesions are very common in the pediatric population and frequently may present on the upper extremity. When evaluating these skin lesions, it is helpful to classify them based on the developmental time of onset as congenital/infantile or acquired. Additionally from the clinical features and histopathologic findings, benign cutaneous neoplasms may also be categorized based on the tissue of origin including epidermal, melanocytic, dermal, or vascular. This chapter discusses numerous congenital/infantile skin lesions (epidermal nevi, congenital nevi, digital fibromatosis, myofibromatosis, hemangiomas, port-wine stains, venous malformations, lymphangiomas) and numerous acquired skin lesions (warts, molluscum, poroma, acquired nevi, lentigo, xanthogranuloma, fibrokeratoma, dermatofibroma, telangiectasia, pyogenic granuloma, angiokeratoma). The discussion includes corresponding clinical photographs and dermatologic descriptions that will assist in developing a differential diagnosis for future clinical identification of these cutaneous neoplasms. This framework of skin lesion categorization will in turn provide guidance for the appropriate evaluation and management of benign skin lesions that present on the pediatric upper extremity.

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References

  • Abzug JM, Cappel MA. Benign acquired superficial skin lesions of the hand. J Hand Surg Am Vol. 2012;37(2):378–93; quiz 93 [Review].

    Article  Google Scholar 

  • Alikhan A, Ibrahimi OA, Eisen DB. Congenital melanocytic nevi: where are we now? Part I. Clinical presentation, epidemiology, pathogenesis, histology, malignant transformation, and neurocutaneous melanosis. J Am Acad Dermatol. 2012;67(4):495.e1–17; quiz 512–4 [Review].

    Article  Google Scholar 

  • Baselga E, Cordisco MR, Garzon M, Lee MT, Alomar A, Blei F. Rapidly involuting congenital haemangioma associated with transient thrombocytopenia and coagulopathy: a case series. Br J Dermatol. 2008;158(6):1363–70 [Case reports].

    Article  CAS  PubMed  Google Scholar 

  • Baselga E, Wassef M, Lopez S, Hoffman W, Cordisco M, Frieden IJ. Agminated, eruptive pyogenic granuloma-like lesions developing over congenital vascular stains. Pediatr Dermatol. 2012;29(2):186–90 [Case reports].

    Article  PubMed  Google Scholar 

  • Boon LM, Mulliken JB, Enjolras O, Vikkula M. Glomuvenous malformation (glomangioma) and venous malformation: distinct clinicopathologic and genetic entities. Arch Dermatol. 2004;140(8):971–6 [Research support, Non-U.S. Gov’t].

    Article  PubMed  Google Scholar 

  • Brandling-Bennett HA, Morel KD. Epidermal nevi. Pediatr Clin N Am. 2010;57(5):1177–98 [Review].

    Article  Google Scholar 

  • Brouillard P, Ghassibe M, Penington A, Boon LM, Dompmartin A, Temple IK, et al. Four common glomulin mutations cause two thirds of glomuvenous malformations (“familial glomangiomas”): evidence for a founder effect. J Med Genet. 2005;42(2):e13 [Research support, N.I.H., Extramural Research Support, Non-U.S. Gov’t Research Support, U.S. Gov’t, P.H.S.].

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Brown J, Janniger CK, Schwartz RA, Silverberg NB. Childhood molluscum contagiosum. Int J Dermatol. 2006;45(2):93–9 [Review].

    Article  PubMed  Google Scholar 

  • Campbell LB, Petrick MG. Mohs micrographic surgery for a problematic infantile digital fibroma. Dermatol Surg. 2007;33(3):385–7 [Case reports].

    CAS  PubMed  Google Scholar 

  • Campbell T, Dimitropoulos VA, Brown Jr C. Successful treatment of eruptive unilateral angiokeratomas. Arch Dermatol. 2008;144(12):1663–4 [Case reports letter].

    Article  PubMed  Google Scholar 

  • Chakkittakandiyil A, Phillips R, Frieden IJ, Siegfried E, Lara-Corrales I, Lam J, et al. Timolol maleate 0.5 % or 0.1 % gel-forming solution for infantile hemangiomas: a retrospective, multicenter, cohort study. Pediatr Dermatol. 2012;29(1):28–31 [Multicenter study].

    Article  PubMed  Google Scholar 

  • Chen C-C, Chang Y-T, Liu H-N. Clinical and histological characteristics of poroid neoplasms: a study of 25 cases in Taiwan. Int J Dermatol. 2006;45(6):722–7.

    Article  PubMed  Google Scholar 

  • Chiu YE, Drolet BA, Blei F, Carcao M, Fangusaro J, Kelly ME, et al. Variable response to propranolol treatment of kaposiform hemangioendothelioma, tufted angioma, and Kasabach-Merritt phenomenon. Pediatr Blood Cancer. 2012;59(5):934–8 [Case reports research support, N.I.H., Extramural].

    Article  PubMed Central  PubMed  Google Scholar 

  • Coloe J, Burkhart CN, Morrell DS. Molluscum contagiosum: what’s new and true? Pediatr Ann. 2009;38(6):321–5 [Review].

    Article  PubMed  Google Scholar 

  • Croteau SE, Liang MG, Kozakewich HP, Alomari AI, Fishman SJ, Mulliken JB, et al. Kaposiform hemangioendothelioma: atypical features and risks of Kasabach-Merritt phenomenon in 107 referrals. J Pediatr. 2013;162(1):142–7 [Research support, N.I.H., Extramural Research Support, Non-U.S. Gov’t].

    Article  PubMed Central  PubMed  Google Scholar 

  • Fernandez-Pineda I, Lopez-Gutierrez JC, Chocarro G, Bernabeu-Wittel J, Ramirez-Villar GL. Long-term outcome of vincristine-aspirin-ticlopidine (VAT) therapy for vascular tumors associated with Kasabach-Merritt phenomenon. Pediatr Blood Cancer. 2013;60(9):1478–81 [Clinical trial multicenter study].

    Article  PubMed  Google Scholar 

  • Gibbs S, Harvey I, Sterling J, Stark R. Local treatments for cutaneous warts: systematic review. BMJ. 2002;325(7362):461 [Research support, Non-U.S. Gov’t review].

    Article  PubMed Central  PubMed  Google Scholar 

  • Goh SGN, Calonje E. Cutaneous vascular tumours: an update. Histopathology. 2008;52(6):661–73 [Review].

    Article  CAS  PubMed  Google Scholar 

  • Hanna D, Hatami A, Powell J, Marcoux D, Maari C, Savard P, et al. A prospective randomized trial comparing the efficacy and adverse effects of four recognized treatments of molluscum contagiosum in children. Pediatr Dermatol. 2006;23(6):574–9 [Comparative study randomized controlled trial].

    Article  PubMed  Google Scholar 

  • Holmes WJM, Mishra A, McArthur P. Intra-lesional steroid for the management of symptomatic Infantile Digital Fibromatosis. J Plast Reconstr Aesthet Surg JPRAS. 2011;64(5):632–7 [Comparative study].

    Article  CAS  Google Scholar 

  • Hosler GA, Moresi JM, Barrett TL. Nevi with site-related atypia: a review of melanocytic nevi with atypical histologic features based on anatomic site. J Cutan Pathol. 2008;35(10):889–98 [Review].

    Article  PubMed  Google Scholar 

  • Kienast AK, Hoeger PH. Cutis marmorata telangiectatica congenita: a prospective study of 27 cases and review of the literature with proposal of diagnostic criteria. Clin Exp Dermatol. 2009;34(3):319–23 [Review].

    Article  CAS  PubMed  Google Scholar 

  • Kilcline C, Frieden IJ. Infantile hemangiomas: how common are they? A systematic review of the medical literature. Pediatr Dermatol. 2008;25(2):168–73 [Review].

    Article  PubMed  Google Scholar 

  • Laskin WB, Miettinen M, Fetsch JF. Infantile digital fibroma/fibromatosis: a clinicopathologic and immunohistochemical study of 69 tumors from 57 patients with long-term follow-up. Am J Surg Pathol. 2009;33(1):1–13.

    Article  PubMed  Google Scholar 

  • Liu DTL, Choi PCL, Chan AYK. Juvenile xanthogranuloma in childhood and adolescence: a clinicopathologic study of 129 patients from the Kiel pediatric tumor registry. Am J Surg Pathol. 2005;29(8):1117; author reply -8 [Comment letter].

    PubMed  Google Scholar 

  • McLaughlin JS, Shafritz AB. Cutaneous warts. J Hand Surg Am Vol. 2011;36(2):343–4 [Review].

    Article  Google Scholar 

  • Mentzel T, Wiesner T, Cerroni L, Hantschke M, Kutzner H, Rutten A, et al. Malignant dermatofibroma: clinicopathological, immunohistochemical, and molecular analysis of seven cases. Mod Pathol. 2013;26(2):256–67 [Case reports].

    Article  PubMed  Google Scholar 

  • Netscher DT, Baumholtz MA, Popek E, Schneider AM. Non-malignant fibrosing tumors in the pediatric hand: a clinicopathologic case review. Hand. 2009;4(1):2–11.

    Article  PubMed Central  PubMed  Google Scholar 

  • Oh C-K, Son H-S, Kwon Y-W, Jang H-S, Kwon K-S. Intralesional fluorouracil injection in infantile digital fibromatosis. Arch Dermatol. 2005;141(5):549–50 [Case reports].

    Article  PubMed  Google Scholar 

  • Osio A, Fraitag S, Hadj-Rabia S, Bodemer C, de Prost Y, Hamel-Teillac D. Clinical spectrum of tufted angiomas in childhood: a report of 13 cases and a review of the literature. Arch Dermatol. 2010;146(7):758–63 [Comparative study].

    Article  PubMed  Google Scholar 

  • Palicka GA, Rhodes AR. Acral melanocytic nevi: prevalence and distribution of gross morphologic features in white and black adults. Arch Dermatol. 2010;146(10):1085–94 [Research support, Non-U.S. Gov’t].

    Article  PubMed  Google Scholar 

  • Paller AS, Syder AJ, Chan YM, Yu QC, Hutton E, Tadini G, et al. Genetic and clinical mosaicism in a type of epidermal nevus. N Engl J Med. 1994;331(21):1408–15 [Research support, Non-U.S. Gov’t Research Support, U.S. Gov’t, P.H.S.].

    Article  CAS  PubMed  Google Scholar 

  • Park HJ, Park KW, Byun DG, Kim HO, Cho BK. Tufted angioma on the palm. Pediatr Dermatol. 2001;18(5):455–6 [Case reports letter].

    Article  CAS  PubMed  Google Scholar 

  • Perkins P, Weiss SW. Spindle cell hemangioendothelioma. An analysis of 78 cases with reassessment of its pathogenesis and biologic behavior. Am J Surg Pathol. 1996;20(10):1196–204 [Case reports review].

    Article  CAS  PubMed  Google Scholar 

  • Piraccini BM, Fanti PA, Iorizzo M, Tosti A. Juvenile xanthogranuloma of the proximal nail fold. Pediatr Dermatol. 2003;20(4):307–8 [Case reports].

    Article  PubMed  Google Scholar 

  • Quitkin HM, Rosenwasser MP, Strauch RJ. The efficacy of silver nitrate cauterization for pyogenic granuloma of the hand. J Hand Surg Am Vol. 2003;28(3):435–8.

    Article  Google Scholar 

  • Raygada M, Arthur DC, Wayne AS, Rennert OM, Toretsky JA, Stratakis CA. Juvenile xanthogranuloma in a child with previously unsuspected neurofibromatosis type 1 and juvenile myelomonocytic leukemia. Pediatr Blood Cancer. 2010;54(1):173–5 [Case reports research support, N.I.H., Extramural].

    Article  PubMed Central  PubMed  Google Scholar 

  • Schachner L, Hansen R. Pediatric dermatology. Edinburgh: Mosby Elsevier; 2011.

    Google Scholar 

  • Sommer S, Merchant WJ, Sheehan-Dare R. Severe predominantly acral variant of angiokeratoma of Mibelli: response to long-pulse Nd:YAG (1064 nm) laser treatment. J Am Acad Dermatol. 2001;45(5):764–6 [Case reports].

    Article  CAS  PubMed  Google Scholar 

  • Tanglertsampan C, Chanthothai J, Phichawong T. Unilateral nevoid telangiectasia: case report and proposal for new classification system. Int J Dermatol. 2013;52(5):608–10 [Case reports].

    Article  PubMed  Google Scholar 

  • Tsubota A, Akiyama M, Sakai K, Goto M, Nomura Y, Ando S, et al. Keratin 1 gene mutation detected in epidermal nevus with epidermolytic hyperkeratosis. J Investig Dermatol. 2007;127(6):1371–4 [Case reports research support, Non-U.S. Gov’t].

    Article  CAS  PubMed  Google Scholar 

  • Willard KJ, Cappel MA, Kozin SH, Abzug JM. Congenital and infantile benign skin lesions affecting the hand and upper extremity, part 2: nonvascular neoplasms. J Hand Surg Am Vol. 2013a;38(11):2284–92.

    Article  Google Scholar 

  • Willard KJ, Cappel MA, Kozin SH, Abzug JM. Congenital and infantile skin lesions affecting the hand and upper extremity, part 1: vascular neoplasms and malformations. J Hand Surg Am Vol. 2013b;38(11):2271–83.

    Article  Google Scholar 

  • Wong A, Hardy KL, Kitajewski AM, Shawber CJ, Kitajewski JK, Wu JK. Propranolol accelerates adipogenesis in hemangioma stem cells and causes apoptosis of hemangioma endothelial cells. Plast Reconstr Surg. 2012;130(5):1012–21 [In vitro research support, N.I.H., Extramural].

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Wright DR, Frieden IJ, Orlow SJ, Shin HT, Chamlin S, Schaffer JV, et al. The misnomer “macrocephaly-cutis marmorata telangiectatica congenita syndrome”: report of 12 new cases and support for revising the name to macrocephaly-capillary malformations. Arch Dermatol. 2009;145(3):287–93.

    Article  PubMed  Google Scholar 

  • Yamamoto T, Umeda T, Nishioka K. Dermatofibroma of the digit: report of six cases. Dermatology. 2003;207(1):79–81 [Case reports letter].

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Mark A. Cappel .

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Cappel, M.A., Willard, K.J. (2014). Skin Lesions. In: Abzug, J., Kozin, S., Zlotolow, D. (eds) The Pediatric Upper Extremity. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8758-6_67-1

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  • DOI: https://doi.org/10.1007/978-1-4614-8758-6_67-1

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