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July 2007

Diffuse Cutaneous Nodules—Quiz Case

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Arch Dermatol. 2007;143(7):937-942. doi:10.1001/archderm.143.7.937-c

A 71-year-old man with a history of prostate carcinoma developed multiple nontender subcutaneous nodules over a 3- to 6-month period. Initial treatment of his prostate cancer included radiation therapy and leuprolide acetate injections. Because his response to treatment was minimal, he was labeled hormone refractory. He was subsequently unavailable for follow-up, but 4 years later, he was admitted to the inpatient medicine unit with a bleeding rectal mass.

Physical examination revealed a cachectic elderly man with multiple firm, mobile, nontender, subcutaneous nodules ranging from 1 to 3 cm on the face, chest, anterior aspect of the right shoulder (Figure 1, white arrows), back, epigastric region, perirectal area, and thighs. An ulcerated right axillary nodule was also present (Figure 1, black arrow). A punch biopsy specimen (Figure 2 and Figure 3) was obtained from the right axillary nodule.

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