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Bradley T. Kovach, MD; Kenneth T. Calamia, MD; John S. Walsh, MD; William W. Ginsburg, MD
From the Mayo Clinic, Jacksonville, Fla.

Arch Dermatol. 2004;140:919-921.

	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

An otherwise healthy 46-year-old man presented with a 1-year history of an ill-defined acral eruption that had evolved over several weeks into reddish-brown papules and nodules, together with a progressive inflammatory polyarthritis. Skin lesions ranging from several millimeters to several centimeters in diameter were present on the dorsal and palmar aspects of the hands (Figure 1) and on the forearms, extensor elbows, chest, paranasal face, neck, pinnae, and scalp. A skin biopsy revealed an intradermal infiltrate composed predominantly of histiocytes and multinucleated giant cells. Many of the cells had abundant "ground glass" cytoplasm with fine periodic acid-Schiff–positive granules (Figure 2). There was severe stiffness, pain, and swelling associated with bilateral synovitis of the metacarpophalangeal joints, distal and proximal interphalangeal joints, wrists, elbows, shoulders, knees, ankles, and forefeet.

Figure appears in full text version. Figure 1. Hands . . . [Full Text of this Article]

THERAPEUTIC CHALLENGE

SOLUTION

COMMENT



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