(2) In patients with HIV infection, the clinical aspect of the lesions may be atypical, presenting as generalized papules with central
umbilication, macules or perforating annular lesions rather than an annular configuration.
The rash was locally synchronous and had progressed from maculopapular to vesicular and pustular; some lesions displayed black
umbilication and crusting (Figure 1, panels C, D).
(22) The endoscopic appearance of pancreatic heterotopia is that of a small nondescriptive nodule covered by normal duodenal mucosa, often with central
umbilication corresponding to the opening of the main duct.
Varicella usually involves the face before spreading to the extremities, and the lesions are characterized by
umbilication and subsequent crusting.
Clinically, diverse cutaneous lesions--erythema and erythematouswhitish or erythematous-purplish papules--may be noticed which later on break to form
umbilication and crust formation leaving hypochromic scars [17].
After the admission, the patient underwent diagnostic endoscopic study which showed a 5 cm x 6 cm antral submucosal mass with central
umbilication. The mass was causing gastric outlet obstruction.
Dermatology exam showed an indurated nodule with central
umbilication covered by crust and surrounded by a reddish halo (Figure 1(b)).
Lesions caused by MC are small, discrete, waxy dome-shaped papules with central
umbilication that are usually 3 to 5 mm in diameter (figure 5).
An EGD with endoscopic ultrasound was performed at our institution, which redemonstrated the 3.5 cm subepithelial hypoechoic gastric mass that appeared to arise from the gastric muscular wall with central
umbilication and ulceration (Figures 1(a)-1(d)).
In our study we found that the burn patients developed fluid-filled monomorphic vesicles with later central
umbilication. After searching the literature and considering our own findings, we strongly believe that sudden appearance of fluid-filled monomorphic lesions on burn area with later central
umbilication along with unexplained fever could be a sign of EH.
Physical examination revealed two indurated nodules 8-mm and 10-mm in diameter, each with central
umbilication and surrounded by a reddish halo [Figure 1]a.
In immunocompetent persons, the molluscum lesions typically appear as painless, flesh-colored or skin-coloured, dome shaped papules of size 2-3mm with central
umbilication that can appear anywhere on the body, but most often located on the face, neck and intertriginous sites like axilla and popliteal fossa.
