REPORT OF A CASE
A 47-year-old woman with a ureterostomy was referred because of nonpruritic peristomal skin lesions of 4 months' duration. The lesions first appeared on the right side of the upper abdomen; subsequent lesions have appeared on her entire abdomen and right arm. The lesions began as small, discrete, erythematous papules that gradually enlarged to approximately 20 mm, with white atrophic centers and a peripheral rim of telangiectasias (Figs 1 and 2). Approximately 30 lesions were seen, and some of the lesions had a superficial crust.The medical history of this patient included a ureterostomy, cholecystectomy, and intermittent excruciating abdominal pain that began 8 months before the skin eruption. Gastrointestinal evaluation and studies showed normal findings and included an abdominal computed tomographic scan, kidney and abdominal ultrasound, upper and lower gastrointestinal endoscopy, and percutaneous transhepatic cholangiogram. Laboratory studies disclosed the following normal results or findings: complete blood cell