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Histopathologic examination revealed whorls of plump spindle cells in a background of slightly thickened collagen in the superficial dermis. Sparse numbers of lymphocytes were present around adjacent superficial capillary plexus vessels.
The papules and arthritis persisted for more than 6 months after the diagnosis was made, despite therapeutic trials of low-dose oral prednisone and nonsteroidal anti-inflammatory agents. The patient was referred to a physical therapist for maintenance of joint mobility and has been unavailable for further follow-up.
Acral and Ear Papules and Arthritis—Diagnosis. Arch Dermatol. 2003;139(5):657-662. doi:10.1001/archderm.139.5.657-a