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CPT Hon Pak, MC USA; Andrew D. Montemarano, MC, USA; Timothy Berger, MD
Walter Reed Army Medical Center, Washington, DC (Drs Pak and Montemarano), and the University of California, San Francisco (Dr Berger)

Arch Dermatol. 1998;134:231-236.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF A CASE

A 36-year-old white woman presented with a 1-week history of painful nodules on her arms, legs, and hands. For the prior 2 months, she had been under evaluation for a white blood cell count of 11 to 14x10⁹/L and an elevated erythrocyte sedimentation rate of 92 mm/h. The antinuclear antibody, rheumatoid factor, antiphospholipid antibody, cryofibrinogen, cryoglobulin, antistreptolysin antibody, Coxsackievirus, and Parvovirus titers were all normal. Repeated blood cultures yielded no organisms, and a chest x-ray film revealed no abnormalities. An antimicrosomal antibody test demonstrated a titer of 1:100,000 and thyroxine depression. Thyroid replacement therapy was instituted with levothyroxine.

Physical examination revealed 5- to 10-mm purpuric macules and subcutaneous tender nodules, some with a surrounding livedoid pattern, on the extremities and the dorsum of the fingers (Figure 1 and Figure 2) A 4-mm . . . [Full Text of this Article]

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