November 1997

A Papulonecrotic Eruption in a Young Man

Author Affiliations

University of Chicago, Chicago, Ill (Dr M. H. Fretzin), Indiana University School of Medicine, Indianapolis (Dr S. Fretzin), and Michael Reese Hospital and Medical Center, Chicago (Dr D. Fretzin)

Arch Dermatol. 1997;133(11):1453-1454. doi:10.1001/archderm.1997.03890470131021

REPORT OF A CASE  A 30-year-old man presented with a 1.5-year history of intermittent skin lesions. The lesions were painful, under-went spontaneous ulceration, and resolved with scar formation over a 4-to 5-week period. His left arm was affected initially, but the lesions progressed to involve his chest, right arm, hands, and upper thigh area (Figure 1 and Figure 2). His medical history included a congenital retinoblastoma that had been surgically removed in infancy. Physical examination demonstrated numerous 0.5- to 1.2-cm erythematous papules, some with central necrosis. There was no lymphadenopathy or hepatosplenomegaly. The results of the following laboratory studies were normal: complete blood cell count, liver function tests, chemistry profile, and VDRL.A biopsy specimen was obtained from one of the papules, and representative features are seen in Figure 3 and Figure 4. Immunoperoxidase staining with CD45RO and CD30 antibodies is shown in Figure 5.What is your

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