PMC6276500_01
Scattered violaceus nodules, and plaques, some with serous exudate located on the dorsum of the hands.
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Approximately one month after methotrexate was discontinued, the patient developed violaceus and erythematous juicy nodules on the cheeks, trunk, and all four extremities (Figure 1).
Ulcerated tumors bilaterally on hands.
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Over the following months, the development of tumors quickly progressed, and many became ulcerated (Figure 2).
White nodules of the dorsal tongue.
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At this point tumors developed on the dorsal surface of the tongue (Figure 3).
H&E stain of biopsy specimen taken at tumor of right thigh at 10x magnification. A dense dermal atypical lymphoid infiltrate with epidermotropism of atypical lymphocytes into the epidermis.
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At this time, biopsies of the right thigh showed epidermotropism (Figure 4).