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March 2005

Black Nodular Lesions on the Foot—Quiz Case

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Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2005

Arch Dermatol. 2005;141(3):389-394. doi:10.1001/archderm.141.3.389-a

An 18-year-old woman spent 6 months in Tanzania. Six weeks after her return, she noticed dark lesions under her left foot and at the tip of the little toe of her left foot. The lesions did not cause symptoms; however, she had noticed “white eggs” coming from them. While on holiday, she usually wore sandals but occasionally walked barefoot.

Physical examination revealed a black nodule on the plantar aspect of the base of the left big toe and another lesion just underneath the nail of the left little toe. Tiny white oval lesions were visible on the skin surface (Figure 1). The nodules were curetted, and samples were submitted for histologic evaluation (Figure 2 and Figure 3).

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