To the Editor: A 10?year?old girl presented with an asymptomatic ulcerated tumor on her right forearm for 18 months [Figure 1a]. The tumor initially was inconspicuous and then gradually enlarged with painless ulceration in its center [Figure 1b]. Three months later, she developed three nontender new nodules on her right arm, proximal to the initial ulcerated nodule. Her general condition was good. Skin examination revealed a 4 cm × 4 cm tumor, with central ulceration and raised margins. Three diameters in 3–5 cm, round to oval, subcutaneous nodules were palpable over her right forearm. No palpable cervical lymph nodes were detected. Histological examination revealed a tumor composed predominantly of epithelioid cells set in a myxohyaline stroma spanning the entire dermis [Figure 1c].Aggregates of epithelioid cells were distributed in a palisading patt around focal areas of dermal degeneration.