Hyperkeratotic Plaque over the Ankle

© 2017 Indian Dermatology Online Journal | Published by Wolters Kluwer Medknow A 7‐year‐old boy presented with a pigmented and itchy lesion over the right lateral malleolus. The lesion appeared during infancy and had shown slow and progressive growth to attain the present size. The child reported occasional bleeding from the pigmented surface following minor trauma. On examination, a solitary dark‐brownish, well‐circumscribed, hyperkeratotic plaque of 6 cm × 5 cm size was found over the right lateral malleolus [Figure 1]. The surface of the lesion appeared verrucous. The plaque was nontender, firm, noncompressible, and having an irregular surface on palpation. Incision biopsy of the lesion was suggestive of verrucous hemangioma (VH). The lesion was subsequently excised with adequate margins under general anesthesia. Primary closure of the defect was carried out by elevation of the local skin flaps. On follow‐up at 3 months, the excised wound had healed properly with minimal scarring. Histopathological examination of the lesion revealed irregular acanthosis and hyperkeratosis of the basal layer of epidermis with dilated blood