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Off-Center Fold
Apr 2012

Plaques on a Butcher's Fingers—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. 2012;148(4):531-536. doi:10.1001/archderm.148.4.531-c

A 63-year-old butcher presented to our dermatology clinic with a 5-year history of infiltrative, nonpainful lesions on the fingers of his left hand. The patient stated that these lesions expanded slowly to their present state and were first seen when he cut his hand while slicing meat. His family physician diagnosed and treated this manifestation as eczema. On physical examination, we found an oval plaque with a maximum diameter of 6.5 cm that nearly surrounded the entire middle finger (Figure 1). The lesion was sharply defined with irregular, raised borders; had a central depression; and was covered with gray, adhesive scales. A few small pustules were also noted. The lesion on the ring finger had a maximum diameter of 4.5 cm and had similar characteristics to that of the third finger (Figure 1). A skin biopsy specimen was obtained for histologic analysis (Figure 2 and Figure 3).

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