A woman in her 80s with a history of hypertension, rheumatoid arthritis, and chronic obstructive pulmonary disease presented with multiple asymptomatic verrucous vegetating lesions on the back of both hands and fingers of the left hand (Figure, A). The lesions had started 5 months before presentation, with progressive enlargement. There was no history of trauma, hospitalization, invasive procedures, or immunosuppression. Punch biopsy specimens of the lesions were obtained for histopathologic analysis (Figure, B and C), and specimens were sent for tissue culture.
Cabral R, Reis JP, Tellechea O. Multiple Verrucous Asymptomatic Lesions in an Elderly Patient. JAMA Dermatol. 2013;149(12):1431-1432. doi:10.1001/jamadermatol.2013.5092