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October 2006

Purpuric Nodule on the Shoulder—Quiz Case

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Arch Dermatol. 2006;142(10):1351-1356. doi:10.1001/archderm.142.10.1351-d

A 34-year-old healthy white man presented with an enlarging lesion on his shoulder. He had a 2- to 3-year history of a nontender, purple nodule that would occasionally swell and pulsate for 1 to 2 weeks and then regress. He had not recently traumatized the lesion.

Physical examination showed a 1.5-cm, purple, compressible nodule with a purpuric rim on the patient's shoulder (Figure 1). The lesion was excised 2 weeks after partially regressing (Figure 2) and submitted for histologic analysis (Figure 3 and Figure 4).