LAUSR

An 85-year-old well-appearing Caucasian gentleman with high blood pressure and hypercholesterolemia presented to clinic for his routine annual skin check. He expressed no concerns at the time of his visit. Exam revealed four asymptomatic well-circumscribed waxy tan dermal nodules with central atrophy and prominent overlying superficial telangiectasias scattered along his scalp measuring between 0.9 and 2.6 cm (Figure 1). The patient denied preceding trauma or recollection of how long these had been present. No similar lesions were found throughout the remainder of the exam, and a generalized musculoskeletal evaluation revealed no clear long bone abnormalities. Review of systems was negative for fevers, night sweats, weight loss, bone pain, polyuria, neuropathy, pruritus, mucosal lesions, and ulceration. Two 4-millimeter punch biopsies were completed with histopathology results demonstrating a palisading granulomatous dermatitis in the reticular and deep dermis