Clinical Challenge: Painful Lesions in Cold Weather

A 27-year-old African American man presents for evaluation of painful "bumps" on his right arm. He explains that they are more painful in cold weather. Physical examination reveals numerous, flesh-colored to hyperpigmented rubbery nodules ranging in size from 0.4 cm to 1.0 cm on the proximal lateral right arm. He states that his father was afflicted with a similar condition.