A 74-year-old white man presented for evaluation of a pruritic eruption on his back. The lesions first appeared 5 months earlier and had spread to his shoulders and upper arms. He reported that a number of the lesions had healed, with scarring, while others had enlarged and become ulcerated.
Physical examination revealed a number of well-circumscribed, nontender, erythematous, violaceous papules, nodules, and nodulo-ulcerative lesions on the patient's back and shoulders (Figure 1). There were also a number of scaly erythematous plaques, some with prominent crusting and others with superficial ulceration, and depressed, atrophic, hypopigmented scars. The lesions ranged from 0.5 to 3 cm in diameter. The findings of the physical examination were otherwise unremarkable. In particular, there was no lymphadenopathy or mucous membrane abnormality. A 4-mm punch biopsy specimen was obtained from an erythematous plaque on the upper back area (Figure 2 and Figure 3).
Flanagan N, Kane D, Sweeney E, Mulcahy F, Barnes L. Crusted Scarring Plaques on the Upper Part of the Back. Arch Dermatol. 1998;134(3):365–370. doi:
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