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September 20, 2010

Necrotic Papules on the Thigh of a 76-Year-Old Woman With Prolonged Fever—Quiz Case

Author Affiliations
 

MARY S.STONEMDSOONBAHRAMIMDCARRIE ANN R.CUSACKMDSENAIT W.DYSONMDMOLLY A.HINSHAWMDARNI K.KRISTJANSSONMD

Arch Dermatol. 2011;147(1):109-114. doi:10.1001/archdermatol.2010.403-a

A 76-year-old woman was seen with a 2-month history of fever, malaise, anorexia, and weight loss of 8 kg within 2 months. She also noticed erythematous crusted papules on her left thigh. Her medical history included hypertension, treated with enalapril for 10 years, and cerebral infarction 3 months earlier. She denied any history of recent traveling and had no history of arthralgia, abdominal pain, cough, diarrhea, or abnormal bleeding. She was treated with a 7-day course of oral valacyclovir for her skin lesions without any improvement.

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