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April 1, 2008

A Protuberant Nodule Under the Foot—Quiz Case

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Arch Dermatol. 2008;144(4):547-552. doi:10.1001/archderm.144.4.547-a

A 58-year-old man presented with a 7-year history of a lump on the plantar aspect of his left foot. The lesion had slowly enlarged within the preceding 2 years. The patient described intense pain of the left foot during walking or exercise.

Dermatological examination revealed a round, rubbery, flesh-colored, 1.5-cm palpable nodule on the volar aspect of the left foot, corresponding with the area of the third metatarsophalangeal joint (Figure 1). The lesion was slightly tender when squeezed between the thumb and index finger. Figure 2 and Figure 3 show a 4-mm punch biopsy specimen obtained from the nodule.