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A Case for Diagnosis. Presented by Dr. E. A. Oliver and Dr. Phillip Geyer.
A man, aged 63, first noticed a cutaneous eruption on the left anterior tibial surface five years before presentation. It remained as a localized patch for three months. Then the entire body was involved. He stated that early in the development of the lesions he noticed vesiculation and later desquamation. There were also periods of acute inflammation associated with severe pruritus and irritation. In the last few years the skin had undergone pigmentary changes, atrophy and wrinkling. About six months ago a lesion appeared on the upper part of the left thigh, which grew rapidly until at the time of the patient's admission to the hospital it was 3 cm. in diameter and extended about 1 cm. above the skin level. The central portion of the lesion was ulcerated, and the edges were rolled and