Multiple mobile and firm subcutaneous nodules on bilateral shins

Abstract

A 40-year-old woman presented with a 10-year history of multiple subcutaneous nodules on the lower extremities. The first subcutaneous nodule occurred on the left shin, and over the last year, had increased in number and spread to the proximal extremities. The general condition of the patient was otherwise healthy, except that she was diagnosed with descending colon cancer and underwent surgery 2 years ago. A physical examination revealed mobile, firm, subcutaneous and asymptomatic nodules symmetrically distributed over the bilateral shins. The size of these nodules ranged from 2 mm to 4 mm in diameter; the number of the nodules was more than 20 (Figure 1). One subcutaneous nodule was taken from the right shin for histological examination. The epidermis and dermis were unremarkable. There were well-demarcated, round-shaped nodules encapsulated by fibrous tissue (Figure 2). Lipo membranous fat necrosis appeared to be associated with focal calcification in the center of the nodule (Figure 3). The skin lesions persisted during a 6-month follow-up.