A previously healthy 42-year-old white woman presented with a 3-month history of an eruption that began as large, tender nodules and rapidly progressed to large, painful, ulcerated tumors involving her face and trunk. She reported no associated fevers, chills, weight loss, or night sweats. She denied a history of cutaneous disease, sexually transmitted diseases, intravenous drug abuse, or alcohol abuse.
Physical examination revealed multiple exudative, ulcerated tumors on the face and trunk, several of which had rolled, violaceous, infiltrated borders, and some of which had a thick overlying crust (Figure 1 and Figure 2). A punch biopsy specimen was obtained for hematoxylin-eosin staining (Figure 3 and Figure 4).
Grossberg EB, Hunek JR, Chaffins ML. Noduloulcerative Lesions on the Trunk and Face—Quiz Case. Arch Dermatol. 2005;141(10):1311-1316. doi:10.1001/archderm.141.10.1311-d