History:

 6 years old female patient who presented with deformity of her right leg and multiple papules and plaques on her right leg since birth . The condition started as a small swelling, red in colour which tended to bleed on scratching . Hx of itching and pain which interfered with her sleep . Deformity of right leg started at age 3 . Inability to walk on her right leg since birth . She sleeps with her leg flexed backwards and hanging it by her hand . There is decrease in her activity .

note: thanks to my colleagues Dr. Obad Abolahom, Dr. H. Almontasar and Dr. Anwer Farhan.