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What Are These White Papules With an Erythematous Base on an Older Man’s Arm?

  • AUTHORS:
    Nicole Edmonds, BA1 • Corina Rusu, MD2 • Barbara B. Wilson, MD3

    AFFILIATIONS:
    1Medical Student, University of Virginia School of Medicine, Charlottesville, Virginia
    2Resident, General Dermatology, University of Virginia School of Medicine, Charlottesville, Virginia

    3Associate Professor of Dermatology, University of Virginia School of Medicine, Charlottesville, Virginia

    CITATION:
    Edmonds N, Rusu C, Wilson BB. What are these erythematous papules on an older man’s arm? Consultant. 2022;62(5):e9-e10. doi:10.25270/con.2021.04.00019

    Received December 2, 2020. Accepted February 9, 2021. Published online April 30, 2021.

    DISCLOSURES:
    The authors report no relevant financial relationships.

    CORRESPONDENCE:
    Nicole Edmonds, 1221 Lee St, PO Box 800718, UVA Health System, Charlottesville, VA 22908 (NLE2FY@hscmail.mcc.virginia.edu)


     

    A 70-year-old man presented to our dermatology clinic with a 1-week history of 1- to 2-mm papules with an erythematous base on his right wrist (Figure 1). He denied any associated pain, pruritus, or systemic symptoms.

    Figure 1. Cluster of white 1- to 2-mm papules on the ventral aspect of the patient’s forearm.
    Figure 1. Cluster of white 1- to 2-mm papules on the ventral aspect of the patient’s forearm.

     

    He reported that 1 month prior, he had developed a rash caused by exposure to poison ivy on the same location on his right wrist, which had resolved within 2 weeks with a topical steroid cream prescribed by his family medicine physician (Figure 2).

    Figure 2. Tense bullae with surrounding erythema of a poison ivy rash on the ventral forearm
    Figure 2.
    Tense bullae with surrounding erythema of a poison ivy rash on the ventral forearm

     

     


    Answer and discussion on next page.