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A Case for Diagnosis (Tuberculosis? Sporotrichosis?). Presented by Dr. Frank C. Combes.
A. G., an East Indian seaman aged 31, was admitted to Bellevue Hospital complaining of lumps on the left arm.
There are four discrete, nontender subcutaneous nodules, each about ½ inch (1.3 cm.) in diameter. One located anteriorly to the medial epicondyle of the left humerus is freely movable. Thick, cordlike structures run from this lesion up the arm and down the forearm, following the course of the regional lymphatics. The left ulnar nerve is distinctly felt in its usual location. The remaining three lesions are found on the dorsal aspect of the forearm and arm a few inches from the left elbow. These lesions are slightly adherent to the overlying skin, which is ulcerated in some areas.
Neurologic examination revealed no abnormalities, and roentgen examination of the chest showed it to be normal. The Wassermann and Kahn reactions
Combes FC, Gross P. NEW YORK ACADEMY OF MEDICINE, SECTION OF DERMATOLOGY AND SYPHILIS. Arch Derm Syphilol. 1943;48(1):129–134. doi:10.1001/archderm.1943.01510010133024
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