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JAMA Dermatology Clinicopathological Challenge |

Erythematous Plaques and Violaceous Nodules on Extensor Surfaces QUIZ

Andrew Raul Villanueva, BS1; Laurence Bradley, MD2; Ife Rodney, MD2
[+] Author Affiliations
1Howard University College of Medicine, Washington, DC
2Department of Dermatology, Howard University Hospital, Washington, DC
JAMA Dermatol. 2016;152(3):331-332. doi:10.1001/jamadermatol.2015.4945.
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A woman in her 60s presented with a 6-month history of itchy eruptions that initially started on the arms and then spread to involve the lower legs. The patient reported no fevers, fatigue, myalgias, arthritis, shortness of breath, oral ulcers, or recent infections. Punch biopsy showed neutrophilic infiltrate. What is your diagnosis?

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Figure 1.
A, Erythematous macules, patches, and plaques along the lower leg; B, a nontender violaceous nodule on the metatarsophalangeal joint; C,a punch biopsy specimen of a plaque showing neutrophilic infiltrate (hematoxylin-eosin, original magnification x 20); D, this is the same specimen at greater magnification (hematoxylin-eosin, original magnification x 40).
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