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
Biopsy specimens of both nodules showed noncaseating epithelioid granulomas in the subcutaneous tissue; no involvement of tendons was observed. Grocott methenamine-silver stains were negative for fungal elements, and Ziehl-Neelson stains were negative for acid-fast bacilli. Foreign bodies were not seen with polarized light.
The patient also had bilateral hilar and mediastinal adenopathy (observed on chest radiography), and the findings of biopsy of a subcarinal lymph node were compatible with sarcoidosis. Laboratory studies were notable only for a mild increase in angiotensin-I–converting enzyme (58 U/L; reference range, 8-52 U/L) (to convert to nanokatals per liter, multiply by 16.667). The patient later developed subcutaneous nodules on his trunk and arms, which responded well to treatment with topical and intralesional corticosteroids.
Subcutaneous Nodules on the Fingers—Diagnosis. JAMA Dermatol. 2013;149(2):224. doi:10.1001/archderm.149.2.223-h