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A Case for Diagnosis (Arsenical Pigmentation and Hyperkeratosis?). Presented by Dr. George C. Andrews.
M. S., a woman aged 43, first noticed at the age of 15 brown spots on the sides of her neck and on her wrists. She had had no serious sickness except measles prior to that time. There was no history of taking arsenic or other medicines. She had typhoid at the age of 23.
Examination shows dark brown streaks and irregularly shaped patches of pigment in a collaret about the neck extending down over the chest. Some are of the shape of a raindrop. Similar pigment is located about the wrists and extends in a linear fashion up the extensor surfaces of both forearms to the elbows. The dorsa of the hands and the armpits are similarly profusely covered with pigmented spots. Similar pigment is also present in the gluteal folds and about the rectum
Rulison RH, Cannon AB. NEW YORK DERMATOLOGICAL SOCIETY. Arch Derm Syphilol. 1943;48(5):547–562. doi:10.1001/archderm.1943.01510050071021
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