REPORT OF A CASE
A 20-year-old previously healthy man awoke seven days prior to admission with four asymptomatic crusted papules ringed by erythema located on his right posterior elbow (Fig 1). He denied any pain, burning, itching, or other sensation in the affected area and reported he "felt fine." He elected to treat the lesions with bacitracin ointment and did not seek medical attention.Thirty hours prior to admission the patient awoke with new lesions on the left flank and supraumbilical (Fig 2) regions. He became alarmed at this point and sought medical attention. A punch biopsy of the left flank lesion was performed and the patient was referred to the Bethesda (Md) Naval Hospital for evaluation.On initial evaluation, his history revealed no lesional symptomatology and the patient denied any abdominal pain, melena, hematochezia, nausea, vomiting, diarrhea, aphasia, seizures, sleep disturbances, loss of sensation, paresis or paralysis, visual disturbances,
Mitchell DF, Parlette HL. Crusted Papules on the Arm and Trunk. Arch Dermatol. 1987;123(9):1227–1228. doi:10.1001/archderm.1987.01660330138028
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