Expanding the dermatological acronym from BLEND TAN EGG to PEGG: A rare case of painful palmar neurofibroma

Painful skin tumors present a diagnostic challenge due to their diverse presentations. The acronym blue rubber bleb nevus, leiomyoma, eccrine spiradenoma, neuroma, dermatofibroma, tufted angioma, angiolipoma, neurilemmoma, endometrioma, granular cell tumor, and glomus tumor (BLEND TAN EGG) encompasses some of the common causes of painful skin tumors. This case report documents a 24-year-old woman presenting with a painful, solitary palmar nodule confirmed as a neurofibroma after an excisional biopsy. Neurofibromas are frequently asymptomatic, but their location within the tight palmar fascia can lead to significant discomfort. The rarity of this presentation and the difficulty in pre-operative diagnosis highlight the importance of considering palmar neurofibromas as a differential diagnosis for painful skin tumors, particularly in the hand and feet. To enhance the educational value of the existing acronym, we propose its expansion to “BLEND TAN PEGG,” where “P” signifies palmar or plantar neurofibroma.