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January 2013

Blue Papules in a Patient With Neurologic Symptoms—Quiz Case

Author Affiliations
 

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

JAMA Dermatol. 2013;149(1):97. doi:10.1001/2013.jamadermatol.683a

A 65-year-old Hispanic woman presented with a 3-year history of numerous blue papules. Her medical history was significant for persistent headaches and unilateral hearing loss. Family history was remarkable for epilepsy and cerebral hemorrhage. Physical examination disclosed multiple blue-violet papules and nodules (Figure 1) over the face, trunk, and extremities. Magnetic resonance imaging with angiography revealed multiple intracranial enhancing lesions consistent with cavernomas. Colonoscopy findings were unremarkable. Punch biopsy specimens were obtained for histologic confirmation (Figure 2 and Figure 3).

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