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THE 13•Y E A R• OLD GIRL was seen for acne treatment and this agminated patch of blue papules with a faint central linear scar was noticed on her forearm during the encounter. She reported that the area was present ever since she could remember, probably near or since birth. The area was surgically removed about five years prior. She notes that the bumps have started to return over the last few years. She reported that the area was mildly sensitive to pressure, but not excruciating, and it was a definite nuisance when wearing tight sleeved shirts, sweaters or coats. She mentioned that she also had an upcoming appointment with the surgeon for re-evaluation and possible re-excision. Diagnosis: Glomuvenous malformation There is a group of vascular tumors that are both benign and have the presence of glomus cells. They can be divided into two main categories: + G lomu v enou s m a l for m a t ion s (a l s o called glomangioma) + Glomus tumors Glomus tumors usually present as a singu- lar nodule that is often very tender/painful. Glomus tumors commonly occur on the extremities, especially in subungual locations. Glomuvenous ma lformations usua l ly present in early childhood as a group of blue, relatively painless nodules. They can be located anywhere on the body. There are other, ra rer va ria nts, including one associated with muscle cells called a glomangiomyoma and another even rarer ma lignant variant. Some repor t s i ndicate a h ig her i nci- denc e of neu r of ibr om a t o s i s w it h t he condition. A lthough distinct, glomangio- mas can be confused with blue rubber bleb nevus syndrome. Treatment is based on the presence of symptoms and/or location. Surgical excision is the preferred treatment moda lity. For more information, contact Charles E. Crutchfield III, MD, at Crutchfield Dermatology or visit CrutchfieldDermatology.com. ■ CDIVascularCare.com Call us at 952.738.4477 to schedule your patient for a limb salvage evaluation. My goal is to help patients save their limbs. —Michael Cumming, M.D., M.B.A., F.R.C.P.C. Director of Vascular Services " " Advanced below-the-knee and pedal loop endovascular revascularization can restore blood flow, promote healing and prevent limb loss in patients with Critical Limb Ischemia. Before resigning to amputation, think "endovascular first" and ask for an endovascular limb salvage evaluation. BY CHARLES E. CRUTCHFIELD III, MD BY CHARLES E. CRUTCHFIELD III, MD A 13—YE AR—OLD GIRL HA S BLUE BUMPS ON HER ARM. Case of the Month with Crutchfield Dermatology M D N E W S . C O M /// M D N E W S M I N N E S O TA ■ 2 017 D I A G N O S T I C S 0 5