An 11-year-old Black boy with obesity presents to a pediatric outpatient clinic with a 3-month history of an evolving, brown, nevus-like lesion in his left axilla. The lesion first appeared 3 months ago and started as a small, asymptomatic, hyperpig-mented macule but progressively became raised and painful to the patient, prompting an appointment. At the time of the visit, the patient's physical examination reveals a blood pressure of 118/67 mm Hg and a pulse of 61 beats/min. A temperature was not obtained. The area of concern is a soft, homogeneous, brown, fleshy papule located in the left axilla, 3 mm in diameter with regular borders. The papule is oval shaped and appears symmetrical. There is no palpable lymphadenopathy in the neck or axillae. The remainder of the physical examination findings are normal. Due to progression and symptoms, pictures are obtained (Fig 1), and a referral is made to pediatric dermatology for evaluation.
展开▼
