Multiple painful nodules - What is the diagnosis?
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https://doi.org/10.5070/D335w130t1Main Content
Unknown: Multiple painful nodules - What is the diagnosis?
Ganesh Avhad MBBS MD, Ameet Dandale, Smita Ghate, Rachita Dhurat
Dermatology Online Journal 17 (12): 9
LTMMC and GH, Mumbai, Maharashtra, India
A 55-year-old hypertensive, chronic alcoholic and diabetic male, presented with a three-year history of multiple painful skin-colored nodules with discharging sinuses on the forearms, elbows, feet, posterior thighs, and popliteal fossae (Figure 1).
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| Figure 1 | Figure 2 |
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Cutaneous examination revealed tender skin-colored to erythematous, firm nodules on forearm, elbows, feet, posterior thighs, and popliteal fossae. The lesions over feet showed central softening with a few sinuses discharging chalky white material. Systemic examination was normal. X rays of elbows, wrists, knees, ankles, and bilateral great toes showed joint space reduction associated with bony destruction. Polarizing microscopy of fine needle aspiration cytology from a nodule is shown in Figure 2 and histopathology of a nodule is shown in Figures 3 and 4.
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| Figure 3 | Figure 4 |
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