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November 17, 2008

Linear Papules and Nodules on the Neck—Quiz Case

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Arch Dermatol. 2008;144(11):1509-1514. doi:10.1001/archderm.144.11.1509-b

A 51-year-old man presented with skin-colored and erythematous papules and nodules on the nape of his neck (Figure 1). The eruption was present since early childhood and slowly enlarged over the years. Nine years ago he underwent surgery for removal of a solitary and larger plaque at the same site, but it recurred 6 months later. Microscopic examination was not performed on the original surgical specimen. The patient reported that during the past 3 years, the eruption had increased in size and bled on slight trauma. On examination, we found 3 ulcerated nodules (2-3 cm) arranged in a curvilinear fashion on the nape of neck. Multiple, small, skin-colored and yellow papules (2-4 mm) were located in close proximity to the nodules. No regional lymphadenopathy was palpable, and all routine laboratory test results were unremarkable. The entire lesion was excised and underwent histopathologic evaluation with hematoxylin-eosin stain (Figure 2[original magnification ×40]) and Figure 3[original magnification ×200]).

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