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August 1991

Pigmented Lesions in a Patient With Pulmonary Tuberculosis

Author Affiliations

University of the Witwatersrand, Johannesburg, South Africa

Arch Dermatol. 1991;127(8):1224. doi:10.1001/archderm.1991.01680070125022

REPORT OF A CASE  A 63-year-old man was admitted to the hospital complaining of a 1-year history of weight loss, night sweats, and a cough productive of blood-stained sputum. Recently, he had noticed round, pigmented lesions on his buttocks and back but was unaware of the exact duration of the problem. They were asymptomatic and appeared to be increasing in number and size.Examination revealed a cachectic man. His vital signs were normal, and there was no organomegaly. Examination of his skin revealed a number of geometrically perfect, round lesions on his back and buttocks. The size varied from 2 to 20 cm in diameter, and a number of lesions had become confluent (Fig 1). The surface showed a uniform fine scaling enhanced by scratching. There was no variation in color, which was darker than the surrounding skin.A chest roentgenogram showed evidence of fibrosis of the right upper lobe

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