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August 1990

Acute Tender Nodules in a Linear Arrangement

Author Affiliations

Northwestern University Medical Center, Chicago, Ill

Arch Dermatol. 1990;126(8):1091-1092. doi:10.1001/archderm.1990.01670320115023

REPORT OF A CASE  A 55-year-old woman noted tender small nodules that appeared in 1 day on her right flank (Fig 1). One month before the onset of the nodules she was admitted to the hospital because of the sudden onset of right-sided hemiparesis. She had a history of mitral valve stenosis and was noted at the time to have an atrial thrombus and fibrillation. This was thought to be the cause of the basal ganglia infarct noted on computed tomography (CT) of the head. Despite adequate intravenous anticoagulation with heparin, she developed superior mesenteric thrombosis and other peripheral emboli. In addition, she developed a fever that was unresponsive to multiple antibiotics. Cultures of blood, sputum, and urine failed to yield any growth. An intra-abdominal abscess was suspected on the basis of a CT scan revealing a right psoas muscle mass. One day after the CT she noted the onset

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