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October 1994

Progressively Enlarging Painful Annular Plaque on the Hand

Author Affiliations

New York (NY) University Medical Center

Arch Dermatol. 1994;130(10):1313-1314. doi:10.1001/archderm.1994.01690100099018

REPORT OF A CASE  A 47-year-old Jamaican woman presented with a 7-day history of pain and swelling of her left palm. Four days after kneading raw goat meat with the palms of her hands, a small painful red papule appeared on her palm and enlarged peripherally. The patient denied fever, nausea, vomiting, joint pains, or headaches.On examination, a 3-cm round, firm, sharply demarcated, violaceous plaque with central clearing and raised edges was present on the left palm (Figure 1). The affected area was warm and exquisitely tender. The epitrochlear and axillary nodes were not palpable. A punch biopsy specimen from the peripheral edge of the lesion was obtained and tissue was submitted for histopathologic evaluation and culture (Figure 2 through Figure 4).What is your diagnosis?Figure 1.Figure 2.Figure 3.Figure 4.

DIAGNOSIS:  Erysipeloid.

HISTOPATHOLOGIC FINDINGS AND CLINICAL COURSE  Hematoxylin-eosin—stained sections showed slight psoriasiform hyperplasia of the

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