The “dot-in-hole” sign in pediatric cutaneous cysticercosis: a non-invasive diagnosis.

Abstract

Cutaneous cysticercosis can present as non-specific subcutaneous nodules and may be misdiagnosed as other benign soft-tissue lesions. We report the case of a 4-year-old child with two painless nodules on the back. High-resolution ultrasonography demonstrated a subcutaneous cyst containing an eccentric echogenic scolex, producing the characteristic “dot-in-hole” sign. Serology confirmed the diagnosis, ophthalmologic evaluation was normal, and the nodules regressed after albendazole treatment under corticosteroid coverage. This case illustrates how ultrasonography can establish a rapid, non-invasive, radiation-free diagnosis of pediatric cutaneous cysticercosis, avoiding unnecessary surgical excision.