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JAMA Dermatology Clinicopathological Challenge
April 2015

Diffuse Papular Eruption

Author Affiliations
  • 1Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida
  • 2Department of Pathology, University of Miami, Miami, Florida
  • 3Dermatology Service, Department of Veterans Affairs Medical Center, Miami, Florida
JAMA Dermatol. 2015;151(4):443-444. doi:10.1001/jamadermatol.2014.3653

An elderly woman of Bahamian heritage with Fitzpatrick VI skin type presented with a 1-week history of indolent papules all over her body. She was otherwise asymptomatic. Findings from physical examination were notable for discrete skin-colored to pink papules coalescing into plaques on her face, trunk (Figure, A and B), and all 4 extremities. There was no scale or other epidermal change. A punch biopsy for hematoxylin-eosin staining was performed (Figure, C). The patient returned 1 week later with worsening cutaneous eruptions and new complaints of fever, weakness, and malaise. Repeat physical examination revealed splenomegaly and axillary lymphadenopathy. A peripheral blood smear (Figure, D) and other diagnostic tests were performed.

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