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December 2004

Widespread Unilateral Plaques in a 68-Year-Old Woman After Neurosurgery—Quiz Case

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Arch Dermatol. 2004;140(12):1531-1536. doi:10.1001/archderm.140.12.1531-e

A 68-year-old woman was referred to our clinic for evaluation of an asymmetrical eruption of pruritic, scaly papules and plaques on the right side of her body. Fifty years earlier, similar lesions had appeared as 2 solitary plaques on the lateral aspect of her right leg. Her symptoms did not change until 18 years ago, when a bilateral frontal craniotomy was performed to repair a ruptured aneurysm. After the surgery, the initial lesions remained unchanged, but numerous satellite lesions appeared over the entire right side of the patient’s body. There was no sensory or motor impairment after surgery. Her medical history was significant for thyroid disease, and her medications included phenytoin (Dilantin), levothyroxine sodium, and alendronate sodium.

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