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Asha R. Patel, BS; Carlos A. Charles, MD; Carlos A. Ricotti, MD; Paolo Romanelli, MD; Elizabeth Alvarez Connelly, MD
University of Miami, Miami, Florida

Arch Dermatol. 2008;144(9):1217-1222.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF A CASE

A 16-year-old boy presented with massive swelling of his left leg that had progressed over the last year. He complained of tremendous leg pain, which was causing difficulty with ambulation. He denied fever, chills, or a history of infectious disease.

Physical examination revealed several dark brown to violaceous, dome-shaped, 0.5-cm papules and 1.5- to 2.0-cm nodules as well as verrucous intact and ulcerated 4.0- to 5.0-cm tumors on the left lower extremity (Figure 1). Extensive left leg edema and massive inguinal lymphadenopathy were also observed. Radiography and computed tomography demonstrated multiple lytic bone lesions of the femur, spine, hip, and skull. A 4-mm punch biopsy specimen was obtained from a dome-shaped papule (Figure 2 and Figure 3).

Figure appears in full text version. Figure 1.

Figure appears in full text version. Figure 2.

Figure appears in full text version. Figure 3.

What is your diagnosis?

SECTION EDITOR: MICHAEL E. MING, MD, MSCE; ASSISTANT SECTION EDITORS: CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; JACQUELINE M. JUNKINS-HOPKINS, MD; VINCENT LIU, MD; KARLA S. ROSENMAN, MD

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