Diagnosis: Lichen Myxedematosus? Granuloma Annulare? Presented by Dr. Conrad Stritzler.
A 69-year-old housewife is presented with an eruption consisting of firm, pea-sized, skin-colored papules on a purpuric background, grouped about the axillary folds, antecubital areas, elbows, wrists, thighs, and legs. They were first noticed a year ago and new lesions have kept appearing since.The right breast was removed because of a tumor of unknown type 20 years ago. In 1943, she had a "nervous breakdown" and was confined to an institution for three months. She has had parkinsonism for several years.She has taken the following medications: Carter's Little Liver pills, one weekly for several months; aspirin, two-four tablets daily, for headache, for about 1½ years; Grove's Laxative and Bromoquinine, occasionally for a cold; Miltown, 400 mg. 2-4 times daily, for about a year. She is known to be allergic to penicillin.The thyroid gland is not enlarged; there is no