A 52-year-old female presented to emergency department (ED) with a 1-month history of a recurrent painless bleeding lesion in her right hand. She recalled a bird biting her right hand while she was feeding birds in a park 1 week before the onset of symptoms. She was admitted with her right hand covered with blood (Figure 1A). After washing her hand, a bright red papule, without pulsation, surrounded by a collar of epidermis was observed (Figure 1B). An ultrasound image, requested in another ED 10 days prior, revealed a well-vascularized 7-mm deep nodular lesion (Figure 2A and 2B). Saucerization excision of the lesion was performed, and histopathology showed a lobular proliferation of small blood vessels, which erupted through a breach in the epidermis to produce a globular pedunculated tumor (Figure 3A and 3B).
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Published online: March 12, 2018
Accepted: January 25, 2018
Received in revised form: October 13, 2017
Received: August 11, 2017
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