Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
A 46-YEAR-OLD MAN came into our family medicine clinic because he wanted a few “lumps” removed from his left medial elbow and the back of his right thigh and knee. He indicated that he’d had the painless lesions for a long time, but that recently they’d started bothering him because they were getting caught on his clothes.
Other than these lesions, his past medical, social, and surgical histories were unremarkable. He indicated that his mother and 3 of his 5 siblings had similar lesions.
On physical exam, the patient had multiple nontender, soft, pedunculated, and relatively mobile nodules in different sizes (FIGURE 1A). There were also a few well-circumscribed and light brown patches on his left medial elbow (FIGURE 1B), the back of his right thigh, and his upper back.
WHAT IS YOUR DIAGNOSIS?
HOW WOULD YOU TREAT THIS PATIENT?