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A 20-year-old man presented to the orthopedic surgeons with a several-month history of 2 discrete nodules on the dorsal aspect of his right foot. These had slowly increased in size but were asymptomatic. He was referred to the dermatology department for a second opinion. Examination revealed 2 well-circumscribed, soft, mobile, flesh-colored, hemispherical swellings 3 cm in diameter, with surface lichenification, overlying the anklecrease and the lateral malleolus of the dorsal surface of the right foot (Figure 1). He subsequently noticed similar lesions developing over the right tibial tuberosity. No knuckle pads were identified, and there was no evidence of psoriasis. An incisional biopsy specimen was taken (Figure 2 and Figure 3).
Goulding JMR, Knowlson LE, Carr RA, Gee BC. Asymptomatic Nodules on the Foot—Quiz Case. Arch Dermatol. 2009;145(11):1325-1330. doi:10.1001/archdermatol.2009.254-a