A Line Redefining His Jaw
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Joe R. Monroe, MPAS, PA, practices at Dermatology Associates of Oklahoma in Tulsa. He is also the founder of the Society of Dermatology Physician Assistants.

The lesion on this 5-year-old boy’s jaw doesn’t concern him as much as it concerns his mother. Can you provide peace of mind to the whole family?

Question 1 of 1

Lesion on boy's jawline

Two years ago, an asymptomatic lesion manifested along a 5-year-old boy’s jawline. When it didn’t go away on its own, his mother took him to the pediatrician. Unfortunately, the pediatrician could not identify the lesion, but his recommendation was very clear: Remove it.

The patient is referred to dermatology for evaluation and possible treatment. In the clinic, the child appears quite healthy and is talkative. The lesion doesn’t bother him as much as it does his mother, who has noticed the boy’s friends and cousins teasing him about it.

The lesion is a pink linear collection of papules— each 1 to 3.5 mm in width—configured in a curved pattern mimicking the line of the jaw. It runs from near the left oral commissure along the angle of the jaw, measuring a total 14 cm.

Magnification reveals that the lesion is entirely composed of tiny vesicles. No inflammation is appreciated. The lesion is tender to touch. Further palpation reveals that the lesion is quite superficial, with no underlying induration.

The most likely diagnosis is

Koebnerized warts

Lichen striatus

Lymphangioma circumscriptum

Koebnerized mollusca

Clinician Reviews. 2019 October;29(10):1e

This quiz is not accredited for CME.

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