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JAMA Dermatology Clinicopathological Challenge
July 2016

A Serpiginous Plaque on the Trunk

Author Affiliations
  • 1Department of Dermatology, The University of Texas Southwestern Medical Center, Dallas
  • 2Department of Dermatopathology, Miraca Life Sciences, Irving, Texas
  • 3Chapel Hill Dermatology, Chapel Hill, North Carolina
JAMA Dermatol. 2016;152(7):831-832. doi:10.1001/jamadermatol.2016.0348

A man in his 70s presented with a 4.0-cm linear plaque with an 8.0-mm erythematous nodule on one end on his right upper abdomen (Figure, A). The lesion appeared 2 months prior and had been mildly itchy. The patient lived in a farm community that used well water for drinking. He denied wading in local water sources and had not traveled abroad recently. The patient denied systemic symptoms, and further physical examination results were unremarkable. Recent laboratory blood work was notable for peripheral eosinophilia. A punch biopsy was performed (Figure, B).

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