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May 2005

Multiple Painful Cutaneous Nodules—Diagnosis

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Arch Dermatol. 2005;141(5):633-638. doi:10.1001/archderm.141.5.633-b

The epidermis of the skin biopsy specimen was normal. A dense proliferation of spindle-shaped cells with eosinophilic cytoplasm and long nuclei was located in the dermis. These interweaving bundles of cells surrounded the vessels and the pilosebaceous apparatus. There was no cytologic atypia.

The complete blood cell count, serum chemistry profile, and serum erythropoietin levels were within normal limits, except for an increased level of γ-glutamyltransferase (121 U/L [reference range, 7-33 U/L]). Abdominal ultrasonography showed an angioma of the liver but no morphological abnormality of the kidneys or ovaries. Magnetic resonance imaging of the head showed no progression of the tumor. Nifedipine therapy (20 mg/d) was initiated, but the patient was unavailable for follow-up, and the efficacy of the treatment could not be evaluated.

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