A 46-year-old white woman presented with a lifelong history of progressively enlarging bluish nodules on her right hand, the upper part of her limbs, and her trunk. The nodules were tender and painful on exposure to cold. There was no family history of similar skin lesions. She also had occasional mild cramps in the right upper quadrant of her abdomen that would resolve spontaneously.
Physical examination demonstrated bluish-to-purple soft nodules on the upper extremities and trunk. The largest lesions were located on the right hand (Figure 1) and left forearm. There were 8 smaller lesions on the trunk and upper part of the limbs (Figure 2). The liver was enlarged, tender, and palpable at 3 cm on the lower right side of the rib cage.
Badziak D, Martins LEAM, Ioshizumi L, Mulinari-Brenner F, Moritz S. Bluish Nodules on the Trunk and Arms—Case. Arch Dermatol. 2005;141(12):1595-1600. doi:10.1001/archderm.141.12.1595-c