PMC4903138_01
Photograph of the patient's back demonstrating an erythematous skin eruption with patches of desquamation, plaques, and papules.
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The eruption was composed of annular, scalene papules and plaques, some of which were ulcerated (Figure 1).
Plain radiographs of right tibia/fibula (a) and left forearm (b) showing multifocal region of cortical irregularities scattered throughout the diaphysis.
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Roentgenogram of the legs and forearms demonstrated cortical irregularities of the ulnar and radial diaphyses and of the tibial and fibular diaphyses, bilaterally (Figure 2).
Nuclear medicine bone scan of the whole body showing extensive bilateral polyostotic patchy uptake within the distal appendicular skeleton, including the forearms, hands, tibias/fibulas, and feet. ((a) and (b)) Feet and tibiae, respectively. (c) Bilateral forearms and hands. ((d) and (e)) Whole body scans.
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Follow-up bone scintigraphy was impressive for bilateral, extensive polyostotic uptake within the hands, feet, forearms, and tibiae/fibulae (Figures 3(a)-3(e)).
Photograph of the patient's back upon completion of treatment with doxycycline. Note dramatic improvement in lesions with few persistent areas of discoloration.
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At this time, the skin eruption was completely resolved (Figure 4).