Boy with yellow-orange, rough nodule on right thigh.

An 8-year-old otherwise healthy boy presented with a yelloworange, roughnoduleonhismedial right thigh (Figure 1). It hadevolved from a flat discoloration since the age of 3 years, which continued to slowly enlarge and thicken. The patient denied spontaneous bleeding or ulceration, and he had full range of motionanduseofhis extremity.Neitherhe nor his family members reported a history of similar lesions on their body. He did not take any medications, had never been hospitalized, andhadneverhadanymajor surgical procedures.His upper and lower extremities were otherwise normal. On inspection, there was a 4.5 cm × 3.5cm,verrucousplaquewithunderlying fullnessontherightmedial thigh. Therewere alsopunctate vessels evident on thehyperkeratotic surface. Figure 1. Close-up of lesion at presentation. A verrucous, vascular plaque with underlying fullness on the right medial thigh. There were also punctate vessels evident on the hyperkeratotic surface.