Presenter: Rick Lin, DO MPH, Dan Ladd, DO
Dermatology Program: KCOM Dermatology Department
Program Director: Bill Way, DO
Submitted on: Mar 21, 2002
CHIEF COMPLAINT: Multiple Papular Lesions
Signs and symptoms: Patient: 38 year old black female. Patient presented to Dermatology Clinic with the chief •complaint of multiple lesions on skin. The lesions onset 23 years ago, at age 15. The symptom includes severe itching. The lesions were previously diagnosed as keloids.
Other information: Current Medication: The past treatments include topical steroids and oral antihistamines
Multiple elevated papular lesions with diameters ranging from 3-7mm distributed across bilateral arms. Hyperpigmentation are present on these lesions.
1. Deep shave biopsy of lesion from left forearm.
2. CBC – Within Normal Limits
3. Hepatic function panel – Within Normal Limits
4. HIV screen – Negative
5. Hepatitis Panel for A, B, C – Negative
Microscopic Description: hyperkeratotic and acanthotic epidermis with papillomatosis and psoriasiform hyperplasia. Prominent basal pigmentation. Thickening of the subepithelial collagen. Dermal fibrosis. Capillary proliferation, slight chronic inflammation and scattered melanophages.
2. Prurigo Nodularis