A 51-year-old black man presented with nonpainful subcutaneous nodules that had appeared insidiously on his torso, arms, and face over the previous 2 months (Figure 1). He had been undergoing workup for a 5-kg weight loss, cramping abdominal pain, and frequent, loose, nonbloody stools, when lesions in the liver suggestive of metastases were noted on a computed tomographic scan. He had been scheduled for a liver biopsy before dermatologic presentation. His medical history was significant for hypertension, which was controlled with nifedipine therapy, and alcohol abuse. Wheezing, flushing, and other cardiovascular symptoms were absent.
Welsch MJ, Busbey S, Kurtz P, Shea CR. Multiple Subcutaneous Nodules With Unknown Metastases to the Liver—Quiz Case. Arch Dermatol. 2005;141(1):93-98. doi:10.1001/archderm.141.1.93-c