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May 1985

Ulcerating Papulosquamous Eruption and Constipation in a 75-Year-Old Man

Author Affiliations

Washington Hospital Center, Washington, DC

Arch Dermatol. 1985;121(5):675-676. doi:10.1001/archderm.1985.01660050127032

REPORT OF A CASE  The patient, a 75-year-old farmer, was admitted to the Washington Hospital Center, Washington, DC, with a two-year history of a perianal eruption, with fissuring and strictures. Multiple attempts to surgically repair the area had been unsuccessful. During the year prior to admission, the eruption, which waxed and waned in intensity, spread to the scalp, axillae, and trunk. Other symptoms included marked polyuria and polydipsia (he drank 10 L/day), severe constipation, and a 2.7-kg weight loss. The patient was taking dicloxacillin sodium at the time of admission. The remainder of the medical history was unremarkable.Physical examination revealed a slender, alert, elderly man. Major findings were localized to the skin. There were numerous scaly reddish brown papules on the lower abdomen and back. In the occipital region—the scalp, neck, and axillae—the papules coalesced to form plaques, which were deeply eroded and covered with thick crusts (Figs 1

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