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JAMA Dermatology Clinicopathological Challenge
August 14, 2019

Dry Scaly Patches and Nodules in a Middle-aged Man

Author Affiliations
  • 1Department of Dermatology, Peking University First Hospital, Beijing, China
  • 2Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
JAMA Dermatol. 2019;155(10):1185-1186. doi:10.1001/jamadermatol.2019.1987

A man in his 50s presented with a 12-year history of itchy eruptions over the whole body. Multiple nodules appeared on the upper back 1 year previously and gradually increased in number and size. The patient was otherwise healthy and denied a family history of inherited ichthyosis or atopy. Physical examination revealed extensive, dry scaly patches on the trunk, arms, and legs. Several 0.5- to 1-cm, dome-shaped, red papules and nodules were found on the upper back (Figure, A and B). Mildly enlarged lymph nodes were observed on the cervical, axillary, and inguinal regions. Results of routine blood tests, biochemistry analyses, and peripheral blood flow cytometry tests were within normal limits. No atypical cells were found in the peripheral blood. A biopsy specimen was obtained from the nodules on the patient’s back (Figure, C and D).

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