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October 2007

Nodular Lesions on the Arm—Quiz Case

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Arch Dermatol. 2007;143(10):1323-1328. doi:10.1001/archderm.143.10.1323-c

A healthy 66-year-old Brazilian man presented with a 10-year history of an asymptomatic mass of nodules affecting his left arm. The lesion had initially appeared as a papule and had been slowly enlarging since then. The patient reported pulling a tick out of the initial lesion. For many years he had been a rubber worker in the Amazon region.

Physical examination revealed 4 ill-defined, smooth, shiny, elastic nodules on the medial aspect of the right arm (Figure 1). A skin biopsy specimen was obtained and stained with hematoxylin-eosin (Figure 2) and Grocott methenamine–silver (GMS) (Figure 3).

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