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February 1990

Erythematous Nodules on the Hand

Author Affiliations

USN; USN; USNR Naval Hospital, Bethesda, Md

Arch Dermatol. 1990;126(2):240a-240b. doi:10.1001/archderm.1990.01670260111026

REPORT OF A CASE  A 24-year-old man noted asymptomatic, pale, red "bumps" on his left index finger and thumb soon after completing a trauma management course. Within 24 hours, the lesions developed a more dusky erythematous rim and continued to enlarge. Over the next 2 days they enlarged to their maximum size and their centers became boggy. The patient denied fevers, malaise, headache, arthralgias, myalgias, or left-upper-extremity discomfort. The lesions were essentially asymptomatic throughout their development.During the trauma course the patient on several occasions handled goats, usually without gloves. He did not remember any mucocutaneous lesions on the animals, nor did he recall having abrasions or lacerations on his hands. His contacts with the goats occurred 6 to 10 days prior to the onset of the lesions.Physical examination revealed a healthy-appearing man whose mucocutaneous abnormalities were limited to his left hand (Fig 1). On the dorsal aspects of

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