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May 2006

Multiple Violaceous Nodules in a 46-Year-Old Man—Quiz Case

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Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2006

Arch Dermatol. 2006;142(5):641-646. doi:10.1001/archderm.142.5.641-a

A 46-year-old man presented with a 1-year history of painful lesions on his right foot that caused difficulty with ambulation. The lesions had slowly enlarged, and nonpainful lesions subsequently developed on his right leg and abdomen. He denied fevers, chills, weight loss, fatigue, or other systemic complaints.

Physical examination revealed multiple soft, violaceous nodules on the right sole, with extension to the great toe and medial malleolus (Figure 1). The nodules were tender to palpation. Similar-appearing nontender nodules were found in the right popliteal fossa. Two nontender, violaceous, compressible nodules were also evident on the right side of the abdomen (Figure 2). There was no lymphadenopathy or hepatosplenomegaly.