Graft-like plantar lesion secondary to possible dorsal-to-ventral cutaneous transposition

We describe a 3-year-old male patient with an unusual congenital lesion on the plantar surface of the left foot that had been asymptomatic until short ly before presentation. Histologic examination of the plaque revealed a thi nner keratin layer, increased pigmentation, and a pilosebaceous unit with a visible vellus hair. We tentatively hypothesize from this single case that a disruption in the normal sequence of events of morphogenesis, and partic ularly in dorsal-to-ventral orientation, may have occurred in this patient.