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JAMA Dermatology Clinicopathological Challenge
April 11, 2018

Intertriginous Multiple Reddish-Brown Papulonodules

Author Affiliations
  • 1Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
JAMA Dermatol. Published online April 11, 2018. doi:10.1001/jamadermatol.2017.5833

A teenaged male presented with a 7-year medical history of numerous asymptomatic reddish-brownish papules, nodules, and plaques over his whole body. The papules began from his bilateral eyelid margins and extended to his trunk and extremities. He also reported a 7-year medical history of polydipsia and polyuria. Physical examination revealed reddish-brown papules, nodules, and plaques on his periocular areas, perioral areas, neck (Figure, A), shoulder, axillary folds, cubital fossa, wrists, palms, umbilical region, lateral abdomen, inguinal area, anogenital area (Figure, B), popliteal fossa, and ankles. The patient had also been diagnosed with central diabetes insipidus, growth retardation, and hypothyroidism. A skin biopsy was performed at the time of the initial evaluation (Figure, C and D).

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