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Symmetrical Black Plaques on the Toes
Chemene Robinson, MD;
Brian Y. F. Yee, MD;
A. Paul Kelly, MD
King/Drew Medical Center, Los Angeles, Calif
Arch Dermatol. 2000;136:791-796.
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REPORT OF A CASE
A 52-year-old African American woman presented with a 3-year history of a progressively thickening "black rash" on her toes and a 5-year history of tinea pedis. Five months before her initial visit, she underwent a total mastectomy for poorly differentiated infiltrating ductal breast carcinoma and had begun a course of chemotherapy (methotrexate, cyclophosphamide, and fluorouracil). She also had a 10-year history of type 2 diabetes mellitus, which was controlled by glipizide therapy.
Physical examination revealed a slightly obese, but otherwise healthy-appearing woman. There were bilateral, symmetrical hyperpigmented papillomatous plaques on the dorsum of the toes. The plaques extended from the metatarsal phalangeal joint to the proximal nail fold, and there was brown discoloration of all toenails (Figure 1 and Figure 2). The hyponychium was normal. She denied pruritus of the involved areas. A 3-mm punch biopsy . . . [Full Text of this Article]
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