Treatment

Under local anesthesia, the lesion was completely excised and closed primarily. The results of the excisional biopsy were such that no further treatment was deemed necessary. The patient healed with no complications.

Excisional Biopsy

Histologic examination reveals a piece of soft tissue composed of keratinized surface epithelium with underlying fibrous connective tissue containing foreign material (Figures 2 & 3) This material is in the form of small aggregates of granular brownish black particles deposited on delicate collagen fibers especially around small blood vessels and the basement membrane (Figure 2).  Some of this material is deposited on delicate collagen fibers in the superficial lamina propria (Figure 3). 

Figure 2 High power (x200) histology shows H & E stained section with surface epithelium and underlying fibrous connective tissue containing brownish-black granular material deposited on delicate collagen fibers of the basement membrane.

    

Figure 3 High power (x200) histology shows H & E stained section demonstrating the granular brownish black material deposited on delicate collagen fibers in the superficial lamina propria.