Erythematous and Tender Subcutaneous Nodules on Lower Extremities

REPORT OF A CASE A 50-year-old woman was admitted because of a 1-month history of weight loss, malaise, and the presence of several hard, erythematous, tender, nodular lesions (diameter, 1 to 2 cm) on her legs (Figure 1). Physical examination findings were normal except for pallor.Laboratory studies disclosed the following values and results: leukocytes, 7.4 X109/L, without eosinophilia; erythrocytes, 2.73X1012/L; hematocrit, 0.22; hemoglobin, 75 g/L; mean corpuscular volume, 84 fL; platelets, 646 X109/L; serum iron, 1.791 μmol/L; serum transferrin, 3.24 g/L; serum ferritin, 1.6 g/L; antistreptolysin-O, <50 U/mL; rheumatoid factor, <21 U/mL; C-reactive protein, <2 mg/L; serum folic acid, 40 nmol/L; serum vitamin B12,293 pmol/L; serum α-1 antitrypsin, 3 g/L; carcinoembryonic antigen, 3 g/L; serum amylase, 228 U/L; serum lipase, 11 820 U/L; and urinalysis, protein fractions, immunoelectrophoresis, and hepatic enzymes, normal.The electrocardiogram and the roentgenogram of the chest