A Cherry-Red Umbilical Papule in an Infant
REPORT OF A CASE
A 6-month-old infant presented with a cherry-red papule in the umbilicus, which appeared 2 weeks after birth (Figure 1). Parents reported a history of intermittent exudates of small amounts of pus mixed with blood. The lesion did not change in size, it did not respond to treatment with silver nitrate, and there were no signs of infection. The infant had normal growth and mental development. Pregnancy was uncomplicated, and no medications were given during pregnancy.
On examination, a solitary bright erythematous papule, 3 mm in diameter, was seen proximal to the umbilicus (Figure 1, inset). Dermatoscopic findings revealed no vascular structures. The papule was completely removed under general anesthesia (Figure 2). A specimen was sent for histopathologic examination (Figure 3).
What is your diagnosis?
Figure 1.
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Figure 2.
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Figure 3.
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Please e-mail your diagnosis to dermquiz{at}ama-assn.org. You must include your full name, mailing address, and institutional affiliation in the initial e-mail to be eligible to enter the quiz. The first correct respondent will be acknowledged on this site next month and in print in Archives of Dermatology and will also receive a free copy of The Art of JAMA II.
For a complete presentation of this case and an in-depth discussion of the entity, please see next month's edition of the Archives.
Congratulations to the winner of our October quiz, Alexander J. Finn, MD, PhD, Department of Pathology and Laboratory Medicine, University of North Carolina Hospitals, Chapel Hill.
The correct answer to our October challenge was sebaceoma.
For a complete discussion of this case, see the Off-Center Fold section in the November Archives (Teo E-Y, Wang Y-S. Fleshy facial lesion in an 80-year-old Dayak woman. Arch Dermatol. 2009;145[11]:1325-1330).
Next month's quiz will be available on December 21, 2009, at 3 pm Central time.