A Large Congenital Blue Plaque With Papules and Nodules on the Lower Back

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A 9-year-old boy presented for evaluation of a pigmented lesion located on his lower back, over the spine. The lesion had been present since birth and had been growing proportionally with the patient. Physical examination revealed a blue plaque measuring 4 × 16 cm. Multiple small papules and nodules measuring 3–4 mm were noted within the larger plaque (Fig. 1). A magnetic resonance imaging of the back and spine showed no underlying abnormalities. A biopsy taken 7 years before from a nodular area showed histologic features consistent with cellular blue nevus. On request of the patient, a staged excision for complete removal was performed.
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