Teenager with a Bleeding, Red Papule.

Previously published Photo Quizzes are now featured in a mobile app. Get more information at http:// www.aafp.org/afp/apps. A 14-year-old boy presented with a tender red papule on his finger. He first noticed it two months earlier. It bled several times, especially when rubbed by his baseball mitt. He had no medical problems or allergies, and he was not taking any medications. He had no other similar skin lesions, and the review of systems was negative for bleeding problems, easy bruising, and frequent infections. Physical examination revealed a solitary bright-red papule on the distal lateral portion of his left fifth finger (Figure 1). On dermoscopy, the lesion was homogeneously red and surrounded by a white collarette of scale (Figure 2). There was no evidence of a pigment network, pigment globules, or dotted vessels.