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JAMA Dermatology Clinicopathological Challenge
October 19, 2016

An African American Man with Diffuse Erythematous Papules

Author Affiliations
  • 1Department of Dermatology, Henry Ford Hospital, Detroit, Michigan
  • 2Department of Dermatology and Cutaneous Biology, Thomas Jefferson University
JAMA Dermatol. Published online October 19, 2016. doi:10.1001/jamadermatol.2016.3750

An African American male in his 50s with a longstanding history of atopic dermatitis presented with a 20- to 30-year medical history of occasionally pruritic erythematous papules involving the trunk and extremities. He denied associated fevers, chills, night sweats, weight loss, joint pain, cough, difficulty breathing, or chest pain.

Findings from the physical examination revealed red-brown monomorphic papules coalescing into plaques on the face, trunk, and extremities (Figure, A and B). There were thin erythematous plaques with overlying scale on bilateral extensor upper and lower extremities. A 4-mm punch biopsy specimen from his right upper extremity was obtained and stained with hematoxylin-eosin for histopathologic analysis. Periodic acid–Schiff and acid-fast bacilli stains were also performed.

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