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2010:76:5;589-590
doi: 10.4103/0378-6323.69091
PMID: 20827014

Finger like growth and multiple nodules over right upper back

Mohan H Kudur, Sudhir Nayak, Sathish B Pai, H Sripathi, Smitha Prabhu
 Department of Dermatology and Venereology, Kasturba Medical College, Manipal, India

Correspondence Address:
Mohan H Kudur
Department of Dermatology, Kasturba Medical College, Manipal-576 104, Udupi Dist, Karnataka
India
How to cite this article:
Kudur MH, Nayak S, Pai SB, Sripathi H, Prabhu S. Finger like growth and multiple nodules over right upper back. Indian J Dermatol Venereol Leprol 2010;76:589-590
Copyright: (C)2010 Indian Journal of Dermatology, Venereology, and Leprology

Case History

A 31-year-old male agriculturist, presented to skin OPD with asymptomatic multiple nodules over right upper back of 4 years duration. The lesion started as a single skin colored nodule over right upper back which progressed to form multiple nodules within a span of 1 year. These nodules were excised in a local hospital. After 6 months, these nodules reappeared in the same site. There is no history of trauma or any systemic illness before the onset of lesions. Examination revealed large area of atrophied skin over right upper back with multiple skin-colored nodules of varying sizes from 0.5 cm to 5 cm and a finger like growth of 6 cm [Figure - 1]. The posterior part of the lesion showed areas of depigmentation while anterior part showing hyperpigmentation. An ulcer was seen at the tip of the finger like growth. The surface of a large nodule showed telangiectasia. A skin biopsy from a small nodule showed typical histopathological features [Figure - 2] and [Figure - 3].

Figure 1 : Finger-like growth and multiple nodules seen over upper back
Figure 2 : Epidermis showing orthokeratosis, mild acanthosis, and effacement of rete ridges. There is diffuse infiltration of spindle cells throughout dermis extending in to subcutaneous fat (H and E, ×40).
Figure 3 : Storiform pattern of arrangement of spindle cells in dermis (H and E, ×200)

What is Your Diagnosis?



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