Red-yellow Papules and Nodules All over the Body: A Quiz

A65-year-old woman presented with a 5-month history of progressive red-yellow papules and nodules with mild pruritus.The lesions first appeared on the abdomen 20 days after pacemaker implantation and gradually spread to the whole body.The patient's medical history was significant for lumbar disc herniation diagnosed 6 years ago, diabetes mellitus diagnosed 1 year ago with current insulin therapy and bradycardia presenting 6 months ago leading to a diagnosis of sick sinus syndrome and subsequent pacemaker implantation.The patient denies arthralgias or articular deformities, changes in urine output or voiding patterns, hoarseness or visual impairment.Physical examination revealed numerous yellowish, pea-sized, soft papules and nodules involving the scalp, face, trunk, extremities and mucosal sites including conjunctiva, oral cavity, pharynx, anus and vulva.Laboratory studies showed essentially normal