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October 20, 2008

Asymptomatic Plaque on the Face—Quiz Case

Arch Dermatol. 2008;144(10):1383-1388. doi:10.1001/archderm.144.10.1383-b

An 82-year-old African man with an 8-year history of a recurrent, slow-growing tumor on his face was seen at our consult service. The original tumor was locally excised 5 years previously in Nigeria, with gradual recurrence following the procedure. On review of systems, the patient reported a moderate amount of weight loss during the past year. The patient's medical history included treated syphilis, hypertension, hyperlipidemia, atrial fibrillation, and a recent stroke. Physical examination revealed a 4.5 × 5.0-cm pearly, erythematous plaque on the left temple, approximately 5 mm from the left lateral canthus (Figure 1). No lymphadenopathy was present on examination of the head and neck. Computed tomography of the chest revealed a 6-mm pleural density in the right lower lobe. A skin biopsy specimen from the left temple was obtained for histologic examination (Figure 2 and Figure 3).

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