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July 2011

Tender Ulceronecrotic Nodules in a Patient With Leukemia —Quiz Case

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2011;147(7):857-862. doi:10.1001/archdermatol.2011.162-a

A 64-year-old woman with chronic lymphocytic leukemia presented with a 2-week history of burning and painful nodules on her legs, abdomen, and arms. Her eruption started 4 days after she began taking the clinical trial drug navitoclax, a targeted small-molecule antagonist of the antiapoptotic lymphocytic protein Bcl-2. Otherwise, she felt well and denied recent travel.

Physical examination revealed numerous tender, erythematous to ulceronecrotic, 1- to 3-cm nodules on her arms, abdomen, and thighs (Figure 1). The early lesions were slightly erythematous indurated plaques. The later lesions were necrotic and purulent nodules.

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