Figure  2. .

Cutaneous findings. A, Hands of proband (V1) at 6 years of age and his mother (IV2) at 30 years of age, showing multiple ulcerating nodular lesions over dorsal aspects of fingers and knuckles. B, Dorsal feet and left heel with purpuric appearance of individual IV2. C, Left ear of individual V11 at 3 years of age, with ulcerating lesion. D, Face and hands of individual V1 at 8 years of age. The erythematous plaquelike lesions over cheeks, nose, and chin resemble butterfly rash. E, Fingers showing fresh lesions, which appear as bluish-red, indurated, and tender papules.