Slowly Enlarging, Erythematous Macule in a Child

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Abstract
REPORT OF A CASE A 7-year-old boy was brought to the dermatology clinic by his mother for evaluation of a "birthmark." The lesion had appeared on his right cheek at the age of 6 months and had slowly spread to the right submandibular area. According to the mother, a portion of the initial lesion had shown some regression. Over the past year, the advancing border had spread and become raised. The patient reported that the lesions were tender to palpation. He was otherwise in good health. Examination of the skin revealed a partially blanching, erythematous, macular patch on his right cheek, with extension to the right submandibular area (Figure 1). The medial border was raised. A similar-appearing satellite nodule was present on the right side of the chin. An incisional biopsy specimen, which included both the raised and the macular areas, was obtained for histopathologic examination (Figure 2 and Figure

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