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A solitary nodule in a paediatric patient

A 14-year-old boy presented with a 10-year history of a lesion on the right thigh. It had gradually increased in size over the years. There was no family history of similar lesions, and the boy was otherwise well. On physical examination, a firm solitary nodule was seen on the right anterior thigh, which was tender to touch and measured 20 mm in diameter (Fig. 1a). The nodule was well circumscribed, and was red-brown in colour with an obvious blue vascular component seen superficially. The full skin examination was otherwise unremarkable.