Verrucous plaques on the elbows

Abstract

A 52 year-old man presented with a 10-year history of scaly lesions on the elbows. He denied prior evaluation or treatment of these areas. A thorough review of systems was negative. Physical examination found sharply marginated, pinkish-brown, verrucous plaques on the bilateral extensor elbows (Fig 1). The remainder of the cutaneous examination findings were within normal limits. A punch biopsy from the edge of the right elbow plaque was obtained (Figs 2 and 3). Gomori methenamine silver and Ziehl-Neelsen stains for micro-organisms were negative. Tissue culture yielded no growth. Laboratory evaluation was notable for negative quantiFERON gold assay.