An unusual case of multiple nodules on the lower legs

Abstract

A 64-year-old man presented with a 6-week history of lesions on his lower legs (Fig. 1). He had no itching, pain or any other symptoms related to the lesions. His medical history included chronic obstructive pulmonary disease (COPD), hypertension and osteoporosis. His medications included alendronic acid, doxazocin, lisinopril, Evacal D3, amlodipine and the inhalers tiotropium bromide 180 lg, Sirdupla (salmeterol 25 lg, fluticasone 250 lg) and salbutamol 200 lg, all of which he had been taking for many years. Physical examination of the right lower leg revealed a single erythematous, warty nodule. There were three further large, warty, erythematous nodules on the left lower leg. Both legs had surrounding scale and haemosiderin staining. Further systemic examina tion did not reveal any other abnormalities.