Clinical, Radiologic, and Histopathologic Features that Distinguish a Pigmented Plexiform Neurofibroma from a...

Area of Science:

• Dermatology
• Pediatric Dermatology
• Pathology

Background:

• Congenital skin lesions require accurate diagnosis for appropriate management.
• Differential diagnoses for pigmented birthmarks include congenital melanocytic nevi and café au lait macules.
• Becker's nevus with smooth muscle hamartoma is a rare entity.

Purpose of the Study:

• To present a case of a 13-year-old boy with a congenital smooth muscle hamartoma.
• To discuss the clinical presentation and differential diagnoses.
• To emphasize the importance of recognizing this rare condition.

Main Methods:

• Clinical examination of a 13-year-old Hispanic male presenting with widespread brown macules and patches.
• Detailed description of a large, darkly pigmented plaque present since birth.
• Consideration of differential diagnoses including congenital melanocytic nevus (CMN), large café au lait macule (CALM), and Becker's nevus with congenital smooth muscle hamartoma.

Main Results:

• A 13-year-old Hispanic boy presented with a congenital, darkly pigmented plaque.
• The plaque became more apparent with skin tension.
• Differential diagnoses were considered based on clinical findings.

Conclusions:

• Congenital smooth muscle hamartoma can present as a darkly pigmented plaque.
• Clinical differentiation from CMN and CALM is essential.
• This case underscores the importance of considering rare diagnoses in pediatric dermatology.