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Nodule on the Forearm in an Adolescent

A 19-year-old black female sought dermatologic constiltation for a slowly growing nodule on her right forearm. This nodule had been noticed for the last five years. It was asymptomatic and had, on rare occasion, drained serous material. She was otherwise healthy and had no other medical or dermatologic problems. Physical examination showed a 2 x 1.5-cm, firm, rubbery, nontender nodule on the volar surface of the right forearm (Fig. 1). The nodule had a slightly violaceous hue, and the surrounding skin showed hyperpigmentation. The center of the nodule had a small button of granulation tissue, probably secondary to manipulation. Complete excision of the nodule was done. Histopathology is shown in Figures 2 and 3. What is your diagnosis? Figure 2. Numerous blood vessels are present in the eosinophilic hyaline stroma.