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July 2006

Erythematous Papules on the Leg—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(7):921-926. doi:10.1001/archderm.142.7.921-b

A 66-year-old-man presented with a 1-year history of intensely pruritic lesions on his right leg. The lesions had initially developed after his leg was injured by the bumper of an automobile 2 years earlier. His medical history was remarkable for prostate cancer, which had been treated with hormonal therapy over the previous 12 months. His general health was otherwise excellent.

Physical examination of the right leg revealed a circumscribed infiltrated plaque with nearby flesh-colored translucent papules and diffuse erythema (Figure 1). A punch biopsy specimen was stained with hematoxylin-eosin (Figure 2) and periodic acid–Schiff (Figure 3), and cultures for bacteria, fungi, and mycobacteria were obtained.