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February 1991

Tender Nodules on the Legs

Author Affiliations

Mount Sinai Medical Center, Miami Beach, Fla

Arch Dermatol. 1991;127(2):252. doi:10.1001/archderm.1991.01680020121020

REPORT OF A CASE  A 49-year-old man was admitted to Mount Sinai Medical Center, Miami Beach, Fla, for epigastric pain radiating to the back that was associated with fever. He had a history of alcohol abuse, recurrent pancreatitis, and pancreatic pseudocysts. Results from the physical examination revealed abdominal tenderness, ascites, and pleural effusions. Laboratory tests disclosed the following findings and values: leukocytosis; erythrocyte sedimentation rate, elevated; liver function tests, normal; serum amylase, 590 U/L (normal, 30 to 110 U/L); and serum lipase, 1694 U/L (normal, 23 to 208 U/L).Ten days after admission, painful nodules on the lower legs, arthralgia involving the ankles, and eosinophilia developed. The eruption consisted of groups of tender, red, 1- to 3-cm nodules with ill-defined borders on the anterior legs (Figs 1 and 2).A hematoxylin-eosin-stained section of an excisional biopsy specimen is shown in Figs 3 and 4. The nodules resolved within 2 weeks, leaving hyperpig-mentation.

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