A 42-year-old white woman presented with a 25-year history of multiple painful cutaneous nodules on her back, arms, and legs. The first lesion appeared on one of her arms when she was a child. As she aged, the lesions became larger, more numerous, and more painful with cold or physical contact. Her medical history was significant for a resection of 2 benign mammary nodules at the age of 18 years, partial epilepsy at the age of 24 years, and both hysterectomy and resection of a left temporal astrocytoma at the age of 30 years. Two years later, the findings of a radiologic examination and a clinical course that was suggestive of an astrocytoma led to the diagnosis of a second cerebral lesion. A simple clinical and radiologic follow-up was decided on.
Pournaras CC, Comacle P, Moulonguet I, Cavelier-Balloy B, Dubertret L, Basset-Seguin N. Multiple Painful Cutaneous Nodules—Quiz Case. Arch Dermatol. 2005;141(5):633-638. doi:10.1001/archderm.141.5.633-a