Verrucous Papules and Subcutaneous Nodules in a Patient With a Lung Mass

Authors:
Maria C. Bell, BMus, and Jordan B. Heskett, MD
Indiana University School of Medicine

Citation:
Bell MC, Heskett JB. Verrucous papules and subcutaneous nodules in a patient with a lung mass [published online August 28, 2018]. Pulmonology Consultant.

A 52-year-old man with a history of tobacco use presented with a 6-week history of worsening cough, dyspnea, fever, night sweats, and hemoptysis. He also had developed painful skin lesions on his face, trunk, scalp, and bilateral upper extremities beginning 6 days prior to presentation.

Physical examination revealed friable and verrucous papules scattered over the right eyelid margin, nasal dorsum, cheeks, scalp, and neck (Figures 1 and 2). Multiple erythematous and tender subcutaneous nodules were noted on the chest, abdomen, back, and bilateral upper extremities, some with overlying ulceration and pustulation. The posterior cervical lymph nodes were enlarged and freely mobile.

Figure 1.

Figure 2.

Results of chest computed tomography with intravenous contrast revealed a 6.9 × 5.8-cm retrocardiac mass without mediastinal or hilar lymphadenopathy (Figure 3).

Figure 3.