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April 1995

Draining Ulcers With Lymphadenopathy

Author Affiliations

USA;; Cleveland (Ohio) Clinic Foundation

Arch Dermatol. 1995;131(4):485-486. doi:10.1001/archderm.1995.01690160113021

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

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