Insect bite to blame for itchy nodule

IT WAS slightly itchy but did not bleed. On prompting she thought she might have had an insect bite.

Purple red nodules like this are suggestive of a lymphocytoma, a localised collection of lymphocytes in the upper dermis. Biopsy is needed to confirm.

Lupus erythematosus, amelanotic melanoma, Merkel cell tumour and granuloma faciale can look very similar. When a lymphocytoma is secondary to a bite reaction, you also see eosinophils mixed in with the lymphocytes. Lymphocytoma cutis is a reaction pattern rather than a