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Firm Yellowish Nodule on the Face of a 7-year-Old Child: What is Your Diagnosis?

Firm Yellowish Nodule on the Face of a 7-year-Old Child: What is Your Diagnosis?

Dahhouki Sara1, Bennani Mounia1, Douhi Zakia1, Elloudi Sara1, Baybay Hanane1, Mernissi Fatima Zahra1, Fadel Reda2, Kamal Dounia2, Tahiri Layla3, Hammas Naoual3

Journal Title:Journal of Dermatology Research

A 7 year old girl presented at our clinic with a 3 months history of cutanuous nodule on her face, which had gradually increased in size, non painless and pruritic. The dermatological examination revealed a 2 cm size firm erythematosis nodule, yellowish in the center, on the mental region. There was no mucosal involvement. The general physical examination was normal, with no signs of lymph node enlargement. Dermoscopy showed yellowish homogeneous areas in the center of the lesion, whereas, in the outer part, was a milky-red area, traversed by large telangiectatic vessels on a red-orange background. Histology revealed a normal epidermis, in the dermis, a nappe of cellular populations, made up of large, macrophagic-looking cells, with image of phagocytosis of lymphoid cells, was noted. The rest of the dermis showed dense inflammatory infiltrates, composed of neutrophils, plasma cells, lymphocytes and histiocytes. A phenomenon of emperipolesisis was clearly defined. Immunohistochemical staining revealed that the histiocytes were strongly positive for S100 protein, weakly positive for CD68 and negative for CD1a. Cell blood count, liver and kidney function test, chest x-ray and abdominal ultrasonography were all normal.