REPORT OF A CASE
A 68-year-old West African man presented with a 4-day history of a tender eruption on the face, ears, trunk, and upper thighs. There was no associated fever, weakness, or arthralgias. A similar eruption had been recurrent for several years, with each episode responding to oral prednisone prescribed by a local physician in the patient's native country. The patient had a medical history notable for treated syphilis and poliomyelitis. He worked as a grocer and had recently arrived in Boston, Mass, to visit family members.Physical examination revealed an afebrile man with several erythematous, tender, infiltrated plaques and nodules, ranging in size between 2 cm and 6 cm, distributed over the right infraorbital skin, the pinnae of the ears with sparing of the lobules, the upper trunk, arms, and proximal thighs. The mucous membranes, sclerae, nose, nails, and joints appeared normal. There were no palpable nerves and