An Unusual Bruise on the Face of a 20-month-old Boy

Test your visual diagnostic skills with this slide-show case of a young boy with an odd facial lesion of approximately one month's duration.

The 20-month-old was playing on his own and accidentally struck the side of his face against a toy chest. Take a close look at the resulting lump. Is there anything about the lesion that would cause you to suspect a malignancy? What would be in your differential diagnosis for lumps and bumps in childhood? Follow the case in the slides above, provided by Dr. Jonathan Schneider, and put your visual diagnoistic skills to the test.

References:

Suggested Reading

Kose D, Ciftci I, Harmankaya I, et al.  Pilomatrixoma in childhood. J Cancer Res Ther. 2014;10:549-51. doi: 10.4103/0973-1482.137918.

Kwon D, Grekov K, Krishnan M, Dyleski R. Characteristics of pilomatrixoma in children: a review of 137 patients. Int J Pediatr Otorhinolaryngol. 2014;78:1337-1341. doi: 10.1016/j.ijporl.2014.05.023. Epub 2014 Jun 2.

Nathwani S, Lam JM. Common lumps and bumps in children: A colour-coded differential. J Curr Clin Care. 2012;2.

Knight PJ, Reiner CB. Superficial lumps in children: what, when, and why? Pediatrics. 1983;72:147-153.

Chiaramonti A, Gilgor RS. Association of multiple pilomatrixomas and myotonic dystrophy. Arch Dermatol. 1978;114:1363-1365. doi:10.1001/archderm.1978.01640210058018.

Putnam TC. Lumps and bumps in children. Pediatr Rev. 1992;13:371-378.