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JAMA Dermatology Clinicopathological Challenge |

Ulcers of the Ventral Aspect of Fingers QUIZ ONLINE FIRST

Sungat K. Grewal, BS1; Chris T. Derk, MD, MS2; Misha Rosenbach, MD1
[+] Author Affiliations
1Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
2Department of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
JAMA Dermatol. Published online August 31, 2016. doi:10.1001/jamadermatol.2016.2748
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A 42-year-old African American man presented with a 7-month history of fatigue, exertional dyspnea, arthralgias, hand swelling, tender ulcerations, hair loss, and a 50-pound weight loss; he presented with ulcers on his dorsal metacarpophalangeal joints. What is your diagnosis?

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A, Edematous hands with crusted ulcers and surrounding hyperpigmentation overlying dorsal metacarpophalangeal joints and interphalangeal joints. B, Ulcerating papules with crust located in the palmar creases of the priximal interphalangeal joints and distal interphalangeal joints. C, Histopathology. D, Chest computed tomography.

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