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AMA Arch Derm Syphilol. 1953;68(5):586-588. doi:10.1001/archderm.1953.01540110108021.
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Chronic nodular cutaneous granulomas resulting from persistent local reactions to arthropod bites are well recognized. Their clinicopathologic characteristics have been clearly described.1 In the majority of cases, spontaneous resolution occurs and no definitive therapy is required, but in rare instances nodular lesions may persist for months or years and may exhibit progressive enlargement. Allenla attributes this response to a stimulating agent from the arthropod or its venom which maintains its activity over many months. Goldman and his associates1b.c have demonstrated bits of ``cuticular'' material in the upper dermis in histopathologic sections of early lesions and suggest that this material, or a similar retained substance, stimulates the chronic granulomatous reaction. If this hypothesis can be accepted, it would appear that removal of that portion of the nodule containing the offending agent should be followed by resolution of the remaining portion of the lesion. This method was used successfully


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