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February 1994

Cutaneous Erythematous Nodular Lesion in a Crab Fisherman

Author Affiliations

Indiana University Medical School, Indianapolis, and Veterans Administration Medical Center, Indianapolis

Arch Dermatol. 1994;130(2):247-248. doi:10.1001/archderm.1994.01690020115020

REPORT OF A CASE  A 44-year-old white man presented with a 1-year history of a nonhealing lesion on his right ring finger and hand. A variety of topical steroid creams had been used without benefit. The patient was known to enjoy ''crabfishing by hand'' at a river close to his residence.His history was significant for end-stage kidney disease. He had successfully received a cadaveric kidney transplant and was taking azathioprine (Imuran) and systemic corticosteroids. Following his kidney transplant, a spontaneous perforation of the descending colon with abscess formation developed. A splenectomy was required during surgery. His kidney function improved, but, shortly before this admission, secondary hyperparathyroidism developed that was treated with partial parathyroidectomy.The patient had normal vital signs and was in no acute distress. Laboratory tests disclosed the following values: glucose, 6.1 mmol/L (110 mg/dL) (normal, 3.6 to 6.1 mmol/L [65 to 110 mg/dL]); creatinine, 100μmol/L (1.3 mg/dL)

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