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Deba P Sarma, MD Omaha

F 18, left shoulder

CD 68: Positive

Factor XIIIa: Positive

Intact epidermis with a diffuse dermal proliferation of large cells with angulated nuclei, abundant foamy cytoplasm, and well defined cell borders. The nuclei show inconspicuous nucleoli. Several multinucleated Touton-type giant cells are seen. The cytoplasm of the cells stain for CD 68 and Factor XIIIa, but not with S-100 and CD 1a.
The lesion is most commonly seen in children, but it can occur at any age.