Asymptomatic swelling in a 60-year-old scar
2 Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Amrinder J Kanwar
Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
|How to cite this article:
De D, Narang T, Dogra S, Radotra BD, Kanwar AJ. Asymptomatic swelling in a 60-year-old scar. Indian J Dermatol Venereol Leprol 2009;75:97-99
A 65-year-old lady presented with two hard swellings over the forehead for two years before seeking dermatology consultation. She had a penetrative injury in a linear fashion on the forehead when she was 5-year-old. The wound healed with secondary intention leaving behind a single linear scar. Two years back, she noticed a swelling underneath the scar. The swelling was gradually progressive in size, hard to feel, and was associated with slight stretching and purplish discoloration of the overlying scar. Later, she developed another round swelling similar to the previous one in the vicinity underneath an unrelated scar. She had exertional dyspnea of insiduous onset for six months not associated with any other cardiac or pulmonary symptoms. There was no history of fever, loss of weight or appetite, arthralgia, or other systemic complaints. She did not have pain, itching, ulceration, or finger-like extensions on the scar. She was a known diabetic which was controlled with metformin.
On cutaneous examination, she had two distinct lesions over the left side of the forehead [Figure - 1]. The larger lesion was of dimension 8 x 2 cm, disposed linearly. The lesion was subcutaneous, hard, nontender, minimally mobile, and extending beyond the margin of overlying stretched scar. A circumscribed similar swelling measuring 2 x 2 cm was noted in the vicinity. Histopathological features of skin biopsy specimen are shown in [Figure - 2] and [Figure - 3].
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