Friday, September 28, 2007

"Lump" on the shoulder



68 y, White gentleman, with PMH of HTN and COPD, comes in for a “lump” on his shoulder that has been present for several years. He mentions having similar “lumps” on his trunk and back. Skin exam shows an soft, compressible, violaceous, domed 1 cm lesion on the Rt shoulder. Please see the attached picture, before and after compression
What is the most likely diagnosis?

1. Pyogenic granuloma
2. Angiokeratoma
3. Nodular melanoma
4. Venous lake
5. Campbell de Morgan spot