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G. Viglizzo, O. Nemelka, P. Nozza, C. Occella, F. Rongioletti, Congenital smooth muscle hamartoma presenting with an unusual pseudo‐Darier's sign, Clinical and Experimental Dermatology, Volume 31, Issue 1, 1 January 2006, Pages 148–149, https://doi.org/10.1111/j.1365-2230.2005.01959.x
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Conflict of interest: none declared.
A 9‐month‐old boy was seen for a congenital, asymptomatic plaque of the right leg. The patient was in general good health and no history of trauma was reported. His parents reported that the skin lesion elevated and hardened after a few seconds of exposure to the warm air of a hair‐dryer.
On examination, a skin‐coloured, slightly elevated plaque was observed (Fig. 1a). Hypertrichosis was absent. After a few seconds of stimulation with the warm air of a hair‐dryer, the lesion became elevated and thickened, assuming a cobblestone appearance (Fig. 1b). After a few minutes, the plaque flattened. No others stimuli such as stroking, rubbing or cooling caused changes in the affected area.
Histopathological examination showed, under a slight hyperplasia of the epidermis, well‐defined smooth‐muscle bundles in the reticular dermis, orientated in various directions. Some of the bundles had a close relationship with the hair follicles. The muscle cells expressed smooth muscle actin, specific muscle actin and desmin. Large numbers of CD34‐positive spindle‐shaped cells were present in the reticular dermis. A diagnosis of smooth muscle hamartoma was made.
