Vandana Mehta Rai

Multiple painful nodules

A 49-year-old lady presented with multiple painful reddish brown nodules over the body since the age of 15 years. At onset there was only one nodule on the left scapula that gradually increased in size associated with pain on tactile stimulus. Later, over the course of years, she developed multiple small reddish-brown papulonodules on the left forearm, left gluteal region [Figure - 1], and face, and on the right breast around the areola. On further questioning, she gave a history of having undergone hysterectomy a few years back due to nodules in the uterus. There was no history of similar lesions in her mother or sister. All routine investigations such as hemogram, urine analysis, liver and renal function tests, chest X-ray, and ultrasonography of abdomen were normal.