Course: Firm Red-Brown Plaques in a Patient With Systemic Scleroderma
CME Credits: 1.00
Released: 2022-08-17
A man in his 60s with anti-RNA polymerase III antibody–positive systemic sclerosis complicated by scleroderma kidney crisis, heart failure, interstitial lung disease, sclerodactyly, and Raynaud phenomenon while receiving mycophenolate mofetil, 1 g twice daily, presented with a pruritic rash that had been present for 3 months. The patient denied any known preceding triggers or trauma to the area of the rash. He had tried treating with topical aloe, without improvement. Review of systems was negative for any new or worsening constitutional, respiratory, or gastrointestinal symptoms. The patient’s medical history was otherwise unremarkable. Examination findings were notable for firm, red-brown plaques without overlying scale on the proximal upper extremities and anterior trunk (, A and B). There was no appreciable skin tightening in the affected areas. Complete blood cell count with differential was unremarkable. Lesional punch biopsy specimens were obtained (, C and D).
Educational Objective
Based on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis.
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