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JAMA Dermatology Clinicopathological Challenge
July 17, 2019

Painful Indurated Plaques on the Vulva

Author Affiliations
  • 1Department of Dermatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
JAMA Dermatol. Published online July 17, 2019. doi:10.1001/jamadermatol.2019.1979

A woman in her 60s presented with a painful skin eruption on the vulva of 2 months’ duration. The patient had a history of rectal carcinoma with lymph node metastasis and 2 years prior had received low anterior resection plus postoperative chemotherapy (6 cycles of oxaliplatin, calcium folinate, and tegafur). A physical examination revealed well-defined, firm, indurated plaques on the vulva with nodules on the surface (Figure 1A). A biopsy of the left vulva was performed (Figure 1B and C).