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January 2000

Coalescing Green and Yellow Papules on the Feet

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Arch Dermatol. 2000;136(1):113-118. doi:

A 76-year-old man with jaundice and anorexia presented with a 2-week history of an asymptomatic progressive eruption on his left foot. He denied trauma and walking barefoot. Examination revealed multiple, round, discrete, green, 1- to 2-mm flat papules that first appeared on the medial aspect of the left foot (Figure 1) and later appeared in the webs of the toes of both feet (Figure 2). The papules on the medial aspect of the foot coalesced into an exfoliating plaque, revealing normal-appearing, nonedematous underlying skin. Many of the peripheral papules were yellow. The results of potassium hydroxide microscopic examination, fungal culture, and Gram stain of minced skin fragments were negative. A guaiac screen of minced skin fragments was negative for occult blood. The total serum bilirubin level was 397 µmol/L (23.2 mg/dL) (reference range, 1.7-20.5 µmol/L [0.1-1.2 mg/dL]).

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