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June 2009

Exophytic Plaques, Blisters, and Mouth Ulcers—Quiz Case

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Arch Dermatol. 2009;145(6):715-720. doi:10.1001/archdermatol.2009.109-a

A 35-year-old man presented with a 6-month history of a painful blistering eruption on his trunk. He complained of painful warty growths over his groin and axillae and a 1-month history of painful mouth ulcers resulting in odynophagia and 12 kg of weight loss. Findings of a systemic examination were normal. Skin examination showed annular plaques and flaccid blisters on the trunk and limbs. Malodorous and exophytic plaques were seen on the axillae (Figure 1) and groin. Oral erosions and papillomatous vegetating lesions on the angles of the mouth were also present (Figure 2). Hematologic investigations and computed tomographic images of the chest and abdomen were normal. Skin biopsy specimens were taken from the axillary plaque for routine hematoxylin-eosin (Figure 3) and direct immunofluorescence studies.

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