REPORT OF A CASE
A 68-year-old white woman sought medical attention for multiple asymptomatic draining cutaneous ulcers. The ulcers had been present for 6 to 8 years and had gradually increased in size. She was otherwise in good health. The patient had been treating the ulcers with bacitracin ointment.Physical examination revealed a cachectic white woman with a 12×10-cm ulcer with a rolled border on the left lower leg (Figure 1). The left shoulder showed a similar appearing 6×4-cm ulcer (Figure 2), and several smaller lesions were also present on the trunk. Multiple left axillary lymph nodes were palpable as was a large, left inguinal node.Laboratory studies revealed profound iron deficiency anemia (hemoglobin, 51 g/L; mean corpuscle volume, 53.5 fL; and ferritin, 69 μg/L). Findings from serum chemistries, an immunodeficiency profile, and arsenic studies were normal. Chest radiograph, esophagogastroduodenoscopy, colonoscopy, and pelvic examination showed no abnormalities.Biopsy specimens from
Morgan J, Pierson JC, Helm TN, Steck WD. Draining Ulcers With Lymphadenopathy. Arch Dermatol. 1995;131(4):485–486. doi:10.1001/archderm.1995.01690160113021
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