THERE is a skin condition affecting the legs almost exclusively which has been described under various and confusing names. It offers many difficulties in differential diagnosis from well-recognized diseases, and though not seldom seen is rarely discussed adequately, either because it is wrongly diagnosed or because it is uncritically passed over.
THE CLINICAL PICTURE
The dermatosis we refer to consists of irregular, but rather sharply defined, raised plaques of various sizes, composed of hemispherical, closely set, but usually discrete papules. The latter are split-pea-to-bean-sized, sometimes in bead-like arrangement, flesh-colored, dirty-gray-brown, ivory, or sometimes pinkish, chronic and recalcitrant to treatment, and intensely pruritic. The surface of the papules may be smooth or rough or even verrucous. They are set in plaques, often forming a mosaic, beyond which outlying papules may be found. The lesions are usually found on the ankles, particularly on the malleoli, shins, and calves, and rarely in the