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July 2009

Multiple Tender Papules in a 48-Year-Old Man—Quiz case

Author Affiliations
 

MARY S.STONEMD

 

SOONBAHRAMIMDCARRIE ANN R.CUSACKMDSENAIT W.DYSONMDMOLLY A.HINSHAWMDVINCENTLIUMDMemorial Sloan-Kettering Cancer Center, New York, New York

Arch Dermatol. 2009;145(7):829-834. doi:10.1001/archdermatol.2009.143-a

A 48-year-old man without significant medical history presented for evaluation of multiple tender papules on his trunk and upper extremities that had been present for many years. Besides occasional intermittent pinching pain lasting for a few seconds and sensitivity to cold, his skin lesions were asymptomatic. The patient reported similar skin lesions in his brother and father. In addition, his father had a history of bladder cancer.

Results of review of systems were negative for weight loss, fatigue, lower back pain, and hematuria. On physical examination, multiple, smooth, pink dermal papules were noted on his back, chest, and upper extremities (Figure 1). A few of his papules were solitary, while most were distributed in groups in linear and clustered patterns. Few were tender on palpation. The findings from the rest of his examination were unremarkable. A punch biopsy specimen from 1 of the lesions on the left side of his chest was obtained (Figure 2 and Figure 3).

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