Case 1

A 67-year-old man presents with 2 nodules on his elbow. He has never had any skin conditions but 2 years previously was diagnosed with rheumatoid arthritis, which he manages with methotrexate and nonsteroidal anti-inflammatory drugs. The nodules are uncomfortable and aesthetically displeasing, but they are not painful. On examination, 2 large, firm, skin-colored subcutaneous nodules on the elbow are noted. Biopsy is performed, revealing palisading necrobiotic granuloma and a central area of fibrin in the deep dermis.

Can you diagnose the condition in Case 1?

A. Fibromas
B. Nodular scleroderma
C. Subcutaneous granuloma annulare
D. Rheumatoid nodules

Click to the next page for the answer. 

This article originally appeared on Clinical Advisor