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JAMA Dermatology Clinicopathological Challenge
July 2016

Painful Perianal Papules in a Middle-Aged Woman

Author Affiliations
  • 1University of Utah School of Medicine, Salt Lake City
  • 2Departments of Dermatology and Pathology, Penn State Hershey Medical Center, Hershey, Pennsylvania
  • 3Department of Dermatology, University of Utah, Salt Lake City
JAMA Dermatol. 2016;152(7):833-835. doi:10.1001/jamadermatol.2016.0143

A woman in her 50s with a history of Crohn disease (CD) was referred for evaluation of painful perianal skin growths. The growths had been present for 1 year. Physical examination revealed a tender perianal plaque with a papular, cobblestone-like surface (Figure, A). She was taking no medications and had not had active gastrointestinal symptoms of CD in several years. A biopsy specimen from the perianal plaque was obtained (Figure, B and C).

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