Blue-brownish Nodule in the Umbilical Area: A Quiz.

Krajewski PK; Szepietowski JC

doi:10.2340/actadv.v103.18368

Blue-brownish Nodule in the Umbilical Area: A Quiz.

Krajewski PK, Szepietowski JC

Acta dermato-venereologica · 2023 · doi:10.2340/actadv.v103.18368 · PMID:37766660 · PMC10549762

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This quiz presents a case of a blue-brownish nodule in the umbilical area to illustrate cutaneous endometriosis and its diagnostic considerations.

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This educational quiz case presents a patient with a blue-brownish nodule in the umbilical area, highlighting the clinical challenge of diagnosing extrapelvic lesions. The discussion references multiple studies on cutaneous and scar endometriosis to illustrate differential diagnoses and diagnostic pitfalls associated with such presentations. It emphasizes the importance of recognizing rare manifestations like primary umbilical endometriosis through dermoscopic and histopathological evaluation. This paper is centrally about endometriosis — specifically focusing on the diagnosis and presentation of cutaneous endometriosis at the umbilicus.

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References

Chapron C, Marcellin L, Borghese B, Santulli P. Rethinking mechanisms, diagnosis and management of endometriosis. Nat Rev Endocrinol 2019; 15: 666-682. https://doi.org/10.1038/s41574-019-0245-z DOI: https://doi.org/10.1038/s41574-019-0245-z Sharma A, Apostol R. Cutaneous endometriosis. StatPearls. Treasure Island (FL); 2023. Machairiotis N, Stylianaki A, Dryllis G, Zarogoulidis P, Kouroutou P, Tsiamis N, et al. Extrapelvic endometriosis: a rare entity or an under diagnosed condition? Diagn Pathol 2013; 8: 194. https://doi.org/10.1186/1746-1596-8-194 DOI: https://doi.org/10.1186/1746-1596-8-194 Wolf Y, Haddad R, Werbin N, Skornick Y, Kaplan O. Endometriosis in abdominal scars: a diagnostic pitfall. Am Surg 1996; 62: 1042-1044. Loh SH, Lew BL, Sim WY. Primary cutaneous endometriosis of umbilicus. Ann Dermatol 2017; 29: 621-625. https://doi.org/10.5021/ad.2017.29.5.621 DOI: https://doi.org/10.5021/ad.2017.29.5.621 Jaime TJ, Jaime TJ, Ormiga P, Leal F, Nogueira OM, Rodrigues N. Umbilical endometriosis: report of a case and its dermoscopic features. An Bras Dermatol 2013; 88: 121-124. https://doi.org/10.1590/S0365-05962013000100019 DOI: https://doi.org/10.1590/S0365-05962013000100019 Tognetti L, Cinotti E, Tonini G, Habougit C, Cambazard F, Rubegni P, et al. New findings in non-invasive imaging of cutaneous endometriosis: Dermoscopy, high-frequency ultrasound and reflectance confocal microscopy. Skin Res Technol 2018; 24: 309-312. https://doi.org/10.1111/srt.12431 DOI: https://doi.org/10.1111/srt.12431 Scioscia M, Virgilio BA, Lagana AS, Bernardini T, Fattizzi N, Neri M, et al. Differential diagnosis of endometriosis by ultrasound: a rising challenge. Diagnostics (Basel) 2020; 10. https://doi.org/10.3390/diagnostics10100848 DOI: https://doi.org/10.3390/diagnostics10100848 Kyamidis K, Lora V, Kanitakis J. Spontaneous cutaneous umbilical endometriosis: report of a new case with immunohistochemical study and literature review. Dermatol Online J 2011; 17: 5. https://doi.org/10.5070/D33MJ2444N DOI: https://doi.org/10.5070/D33MJ2444N Zhang P, Sun Y, Zhang C, Yang Y, Zhang L, Wang N, et al. Cesarean scar endometriosis: presentation of 198 cases and literature review. BMC Womens Health 2019; 19: 14. https://doi.org/10.1186/s12905-019-0711-8 DOI: https://doi.org/10.1186/s12905-019-0711-8 Published How to Cite License Copyright (c) 2023 Piotr K. Krajewski, Jacek C. Szepietowski This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work. Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.

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