A Knee Pain Referred to a Dermatologist

Aravind Suprakasan, Nayak U. K. Sudhir, Ranjini Kudva
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Abstract

A painful lesion on the skin can arise from any of the cutaneous structures. A 51-year-old man presented with left knee pain of 1-year duration that got aggravated by contact with clothing or light touch. His symptoms failed to improve despite multiple visits to orthopedics and neurologists. On examination, a 1 cm × 2 cm tender nodular lesion was present on the left knee with surface scaling. Dermoscopy showed peripheral scaling with a rich vascular network interlaced with structureless white areas. The lesion was excised, and histopathology showed fibrocollagenous tissue along with a well-circumscribed encapsulated tumor composed of islands and nests of monomorphic cells with round centrally placed nuclei, reported as a glomus tumor. Post excision, the patient was asymptomatic, and no recurrence was observed. Glomus tumors are classically described to arise from fingertips or extremities. Atypical sites can also be involved, with very few cases reported in the literature.
膝关节疼痛转诊至皮肤科医生
皮肤上的疼痛病变可能来自任何皮肤结构。一名 51 岁的男子因左膝疼痛就诊,病程长达 1 年,与衣物接触或轻触时疼痛加剧。他曾多次到骨科和神经科就诊,但症状仍不见好转。经检查,左膝上有一个 1 厘米×2 厘米的触痛性结节病变,表面有脱屑。皮肤镜检查显示,周围脱屑,有丰富的血管网与无结构的白色区域交错。病变被切除,组织病理学显示为纤维胶原组织,以及一个由单形细胞组成的岛状和巢状、核圆形居中的包膜瘤,报告为腺瘤。切除术后,患者没有任何症状,也没有发现复发。据经典描述,腺泡瘤多发于指尖或四肢。非典型部位也有可能受累,但文献报道的病例很少。
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