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July 2007

Painful Nodule on the Knee—Quiz Case

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Arch Dermatol. 2007;143(7):937-942. doi:10.1001/archderm.143.7.937-b

A previously healthy 42-year-old white woman presented with a 1-year history of a painful nodule on her left knee. A biopsy specimen of the lesion had been obtained 9 months earlier, revealing a necrobiotic granuloma consistent with granuloma annulare. The patient was unavailable for follow-up until the lesion recurred and she returned to our clinic because of the discomfort.

Physical examination revealed a 2.0 × 1.5-cm brownish pink nodule with a variegated surface on the lateral aspect of the left knee (Figure 1). The patient was otherwise asymptomatic, and no other abnormalities were noted on physical examination. Punch biopsy specimens were obtained (Figure 2 and Figure 3).

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