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Paronychia and Necrotic Nodules —Quiz Case

Paronychia and Necrotic Nodules —Quiz Case Report of a case A 65-year-old woman presented with a several-day history of tender necrotic lesions on her extremities. The lesions were preceded by erythema of her right great toe that did not respond to β-lactam antibiotic therapy for presumed staphylococcal paronychia. Her medical history was remarkable for aplastic anemia status post induction therapy with antithymocyte globulin, methylprednisolone, and cyclosporine. Physical examination revealed multiple erythematous, edematous nodules with central necrotic eschars on the patient's extremities; the largest one, measuring 3.5 cm, was located on her right wrist (Figure 1). Also, there was periungual erythema with associated vesiculation on her right great toe (Figure 2). Laboratory studies at the time of evaluation were notable for a white blood cell count of 1400/ μL, with an absolute neutrophil count of 700/ μL (to convert values to ×109/L, multiply by 0.001). A punch biopsy specimen was obtained from the lesion on the right thigh (Figure 3) for histologic evaluation and culture studies. View LargeDownload Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. What is your diagnosis? http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Paronychia and Necrotic Nodules —Quiz Case

Paronychia and Necrotic Nodules —Quiz Case

Abstract

Report of a case A 65-year-old woman presented with a several-day history of tender necrotic lesions on her extremities. The lesions were preceded by erythema of her right great toe that did not respond to β-lactam antibiotic therapy for presumed staphylococcal paronychia. Her medical history was remarkable for aplastic anemia status post induction therapy with antithymocyte globulin, methylprednisolone, and cyclosporine. Physical examination revealed multiple erythematous, edematous...
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Publisher
American Medical Association
Copyright
Copyright © 2011 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archdermatol.2011.324-a
Publisher site
See Article on Publisher Site

Abstract

Report of a case A 65-year-old woman presented with a several-day history of tender necrotic lesions on her extremities. The lesions were preceded by erythema of her right great toe that did not respond to β-lactam antibiotic therapy for presumed staphylococcal paronychia. Her medical history was remarkable for aplastic anemia status post induction therapy with antithymocyte globulin, methylprednisolone, and cyclosporine. Physical examination revealed multiple erythematous, edematous nodules with central necrotic eschars on the patient's extremities; the largest one, measuring 3.5 cm, was located on her right wrist (Figure 1). Also, there was periungual erythema with associated vesiculation on her right great toe (Figure 2). Laboratory studies at the time of evaluation were notable for a white blood cell count of 1400/ μL, with an absolute neutrophil count of 700/ μL (to convert values to ×109/L, multiply by 0.001). A punch biopsy specimen was obtained from the lesion on the right thigh (Figure 3) for histologic evaluation and culture studies. View LargeDownload Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. What is your diagnosis?

Journal

Archives of DermatologyAmerican Medical Association

Published: Nov 1, 2011

Keywords: necrosis,paronychia

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