title: Rapidly growing hemorrhagic papule on the cheek of a 54-year-old man.
abstract: A 54-year-old man sought medical attention for a growth on his right cheek that had been present for three months. The growth began as a small, brown “pimple” that gradually increased in size over time. Physical examination revealed a 9 mm well-circumscribed erythematous nodule with a hemorrhagic crust. On dermoscopy, the lesion was completely vascular appearing, with no pigment visualized. A clinical diagnosis of pyogenic granuloma was made. The lesion was biopsied and histopathologic examination revealed a 2.8 mm thick, Clark level IV, ulcerated, amelanotic nodular melanoma. Because the literature contains reports of nodular melanoma mimicking the presentation of a pyogenic granuloma, all such lesions should be biopsied for histopathologic diagnosis.
authors.affiliation: Department of Dermatology, Creighton University Medical School, Omaha, USA. debasarma@creighton.edu
authors.forename: Marianne
authors.initials: M
authors.lastname: Junck
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Huerter
authors.forename: Deba P
authors.initials: DP
authors.lastname: Sarma
mesh_terms: D005153:Facial Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D018328:Melanoma, Amelanotic / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology