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December 1987

Generalized Eruption in a Patient With Pseudoxanthoma Elasticum

Author Affiliations

The Johns Hopkins Medical Institutions, Baltimore

Arch Dermatol. 1987;123(12):1707-1708. doi:10.1001/archderm.1987.01660360168030

REPORT OF A CASE  A 41-year-old woman presented with a three-day history of myalgias, headache, mouth pain, and a diffuse pruritic eruption. She was being followed up in our genetics clinic for pseudoxanthoma elasticum. Therapy consisted of dipyridamole, which she took intermittently. She was reticent about her history and refused a complete physical examination.Cutaneous examination revealed a diffuse eruption consisting of tender, erythematous macules and papules, some of which were eroded, whereas others were scaly (Fig 1). There were palmar and plantar lesions that were variably keratotic papules or deep-seated pustules (Fig 2). She also had nonulcerative, tender, oral erythematous macules.Laboratory tests included a complete blood cell count, which was within normal limits, and two serologic tests for syphilis, the results of which were negative. A skin biopsy specimen was obtained (Figs 3 and 4).What is your diagnosis?

DIAGNOSIS:  Secondary syphilis.


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