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August 1992

Pruritic Ulcerating Bruise in an Elderly Hispanic Man

Author Affiliations

Loyola University Medical Center, Maywood, Ill, and University of Chicago (Ill)

Arch Dermatol. 1992;128(8):1119-1120. doi:10.1001/archderm.1992.01680180113018

REPORT OF A CASE  A 76-year-old Hispanic man presented with a 2-month history of scalp pruritus. One month after onset, a pruritic area over his frontal scalp began to bleed after scratching, then progressed to oozing pus. The affected area thickened, and the skin beyond his anterior hairline also became thickened and dusky red. Two weeks before presentation, his face became swollen, which was most apparent on awakening but became constant.He denied dyspnea, weight loss, fevers, sweats, chills, headache, focal neurologic deficits, or liver disease. He did not have a birthmark on the affected area. Medical history was notable for chronic alcoholism and "renal stones," diagnosed in Mexico but never treated. His only medication was a lowpotency topical steroid, used intermittently on the scalp. He denied allergies. He was born in Mexico and immigrated to the United States after 30 years of age, where he worked in a meat

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