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October 1995

Long-standing Verrucous Lesion

Author Affiliations

Harvard Medical School and Massachusetts General Hospital, Boston

Arch Dermatol. 1995;131(10):1197-1198. doi:10.1001/archderm.1995.01690220103019

REPORT OF A CASE  A 65-year-old Russian woman presented with the complaint of an itchy, atraumatic, slowly growing verrucous plaque on her left lower extremity. The patient stated that the lesion had been excised three times over a period of ''many'' years in Russia and always recurred. To eliminate the pruritus, she had applied a midpotency topical steroid with no apparent benefit.On physical examination, the patient appeared healthy. She had bilateral lower extremity pitting edema (1+) to the ankles and prominent varicose veins. On her left midshin, there was an approximately 6×5-cm irregular, brown verrucous plaque arising from a well-defined, erythematous base (Figure 1). There were a few hemorrhagic crusts. The lesion appeared to arise along several surgical scars and was nontender, slightly firm, and minimally scaly. There was a smaller lesion detected proximally on the left superior thigh. There was no hepatosplenomegaly or adenopathy. A complete blood cell

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