JAMA Dermatology Clinicopathological Challenge
March 2014

Tender Macules and Papules on the Toes

Author Affiliations
  • 1Medical College of Georgia, Georgia Regents University, Augusta

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Dermatol. 2014;150(3):329-330. doi:10.1001/jamadermatol.2013.6717

A young woman presented in mid-November with a 1-month history of painful lesions on several toes. Results from a full review of systems were otherwise negative for disease. She denied any previous health problems, antecedent toe trauma, or illicit drug use. She denied any history of similar lesions. She was unemployed and had walked to her appointment. Her only medication was Depo-Provera for contraception. Physical examination revealed tender, dusky violaceous to pink confluent nonblanching macules studded with a few small, scaly papules on the volar surfaces of the bilateral great toes, right third toe, and left fifth toe (Figure, A). No similar lesions were noted on the hands or other skin sites. A punch biopsy specimen was obtained (Figure, B and C).

First Page Preview View Large
First page PDF preview
First page PDF preview