Case History/Examination
A 70-year-old female with diabetes and heart failure presented with
asymptomatic plaques and nodules on her left hand over six months,
treated unsuccessfully with oral steroids and antibiotics. Physical
examination revealed three cauliflower-like hyperkeratotic nodules with
secondary ulcerations and pustules on the left forearm, without
lymphadenopathy (Fig. 1 – a, b). The patient denied any insect bites,
occupational exposure, or travel history, but reported spending time
gardening.
Methods