Case 100

Dermatopathology Case


  A 61-year-old woman presented with a 3-month history of recurring asymptomatic bumps on her legs. These lesions would periodically ulcerate and drain a cloudy, yellow exudate. The patient suffered from rheumatoid arthritis, managed with low-dose prednisone and etanercept. Constitutionally she felt well. She denied any exposure to whirlpool footbaths, though she did frequently have pedicures in a nail salon. The patient did not recall any previous leg injury. Examination revealed several firm, erythematous papules on her legs, as well as a few deeper dermal to subcutaneous nodules near her ankles. A few of the lesions had overlying erosion. No inguinal adenopathy was noted.

Gross, Ankle

HE, 4


Gross, Knee

AFB, 40


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Source: Department of Pathology, Creighton University Medical Center, Omaha, NE

Gross Photo: Dr. Shehan; Microscopic Photo: Dr. Sarma

Discussion: Zenggang Pan