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Dermatology clinic

A red papule with a yellowish hue

Steven Kossard

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Abstract

A 35-year-old man presents with an asymptomatic yellowish-red papule on his shoulder. What is this lesion?

Article Extract

A 35-year-old man had an asymptomatic, 5 mm papule on his left shoulder which had persisted for six months. Close examination showed a sharply circumscribed, elevated red papule with a yellowish hue (Figure 1). No similar lesions were found on general examination of his skin. Excision biopsy showed an elevated epidermis under which there was a diffuse infiltrate of histiocytes (Figure 2). Many of the histiocytes were multinucleated and had a central wreath of nuclei with a foamy periphery (Touton giant cells). There was a background of lymphocytes, eosinophils and plasma cells between the histiocytes.

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