An unusual periumbilical plaque
Department of Dermatology, OPD-14, 'O' bldg., 2nd Floor, B. Y. L. Nair Ch. Hospital, Dr. A. L. Nair Road, Mumbai Central, Mumbai - 400 008
|How to cite this article:
Mehta B, Amladi S, Nayak C, Savant S. An unusual periumbilical plaque. Indian J Dermatol Venereol Leprol 2008;74:697-698
A 55-year-old menopausal woman presented with an asymptomatic raised lesion around the umbilicus since the past 3 years. The lesion was gradually increasing in size. There was no history of any abdominal surgeries. The patient was hypertensive and on treatment with atenolol 50 mg OD since 4 years. She was a multiparous woman with 4 children.
On examination, the abdominal skin was loose and showed multiple striae gravidarum. The supra-umbilical area showed a well-demarcated, irregular, yellowish, crinkled, grooved plaque about 3 cm in size [Figure - 1]. On palpating the lesion, there was decreased skin turgor and the skin felt inelastic.
Blood biochemistry, including lipid profile and serum calcium, was normal. Electrocardiogram, 2D-echocardiograph and ultrasonography of the abdomen and pelvis were normal. Detailed ophthalmologic examination was normal. Findings of a skin biopsy from the lesion are shown in [Figure - 2],[Figure - 3].
What is your Diagnosis ?
Burrows NP, Lovell CR. Disorders of connective tissue. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's textbook of dermatology. 7 th ed. Blackwell Publishing; 2004. p. 46.21-26.th ed. Blackwell Publishing; 2004. p. 46.21-26.'>[Google Scholar]
Johnson BL Jr, Honig P. Congenital diseases (Genodermatoses). In: Elder DE, Elenitsas R, Johnson BL Jr., Murphy GF, editors. Lever's histopathology of the skin. 9 th ed. Philadelphia: JB Lippincott; 1997. p. 159-61.th ed. Philadelphia: JB Lippincott; 1997. p. 159-61.'>[Google Scholar]
Pruzan D, Rabbin PE, Heilman ER. Periumbilical perforating pseudoxanthoma elasticum. J Am Acad Dermatol 1992;26:642-4.[Google Scholar]
Sapadin AN, Lebwohl MG, Teich SA, Phelps RG, DiCostanzo D, Cohen SR. Periumbilical pseudoxanthoma elasticum associated with chronic renal failure and angioid streaks--apparent regression with hemodialysis. J Am Acad Dermatol 1998;39:338-44.[Google Scholar]