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November 17, 2008

Hyperpigmented Patches on the Trunk of a Nigerian Woman—Quiz Case

Author Affiliations
 

CARRIE ANN R.CUSACKMDSENAIT W.DYSONMDJACQUELINE M.JUNKINS-HOPKINSMDVINCENTLIUMDKARLA S.ROSENMANMD

Arch Dermatol. 2008;144(11):1509-1514. doi:10.1001/archderm.144.11.1509-d

A 33-year-old Nigerian woman who immigrated to the United States 4 years previously presented with mildly itchy, dark, round, scaly patches, mostly on the trunk and proximal extremities, which appeared suddenly 3 months earlier. Two weeks before the onset of the cutaneous eruption, she was hospitalized with fever of unknown origin, nausea, vomiting, and a 43-pound unintentional weight loss over 8 months. She was diagnosed as having sarcoidosis after a workup revealed mediastinal lymphadenopathy, parotid enlargement, hypercalcemia, polyclonal gammopathy, and anemia and bronchoscopy demonstrated mediastinal granulomas, with negative results from serologic examination, cultures, and stains for acid-fast bacilli and fungi.

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