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Pediatric fasciitides are fibroblastic spindle cell proliferations that are often precipitated by trauma. Thought to result from dysregulated healing, these benign lesions are rare and require careful histologic diagnosis.
A 5-month old infant was referred for dry skin. Incidentally, a tender, 6 cm × 6 cm bluish firm mass was noted on his left shoulder. It was unusual: rock hard with a well-demarcated border on one side, yet rubbery on the other side. Questioning revealed that the mass had been present — and growing — for 1 month. Punch biopsy proved insufficient for diagnosis, but plans for deeper biopsy and malignancy work-up were impeded by parental anger and refusal. After discussion with the pediatrician, the parents finally consented.
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