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Pustule-Studded Plaques After Abrasion Injury—Quiz Case

Pustule-Studded Plaques After Abrasion Injury—Quiz Case Report of a case A 59-year-old man presented with a 3-week history of painful, enlarging lesions on his abdomen that had developed after he sustained a pavement abrasion injury. Daily cleansing with hydrogen peroxide was of no benefit. The patient was a recovering alcoholic; his medical history was significant for hypertension, chronic obstructive pulmonary disease, and depression. His medications included albuterol, ipratropium bromide, and fluoxetine. He had no history of halogen ingestion or recent travel. A serologic test had been negative for human immunodeficiency virus infection 4 years earlier. Physical examination revealed 2 vegetating, erythematous, exudative plaques, measuring 9 × 9 and 3 × 7 cm in greatest dimension, on the abdomen. The borders were elevated, violaceous, and irregular but well-demarcated (Figure 1). The plaques were studded with smallpustules (Figure 2) and appeared to be focally eroded. There were a few isolated pustules near the plaques, and typical lesions of ecthyma were present on the hands. Regional lymph nodes were of normal size. The following laboratory parameters were within normal limits: complete blood cell count, serum electrolyte profile, and serum liver transaminase and albumin levels. A punch biopsy specimen (Figure 3) and cultures (aerobic/anaerobic bacterial, mycobacterial, and fungal) were obtained. Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload What is your diagnosis? http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Pustule-Studded Plaques After Abrasion Injury—Quiz Case

Pustule-Studded Plaques After Abrasion Injury—Quiz Case

Abstract

Report of a case A 59-year-old man presented with a 3-week history of painful, enlarging lesions on his abdomen that had developed after he sustained a pavement abrasion injury. Daily cleansing with hydrogen peroxide was of no benefit. The patient was a recovering alcoholic; his medical history was significant for hypertension, chronic obstructive pulmonary disease, and depression. His medications included albuterol, ipratropium bromide, and fluoxetine. He had no history of halogen ingestion...
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Publisher
American Medical Association
Copyright
Copyright © 2006 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.142.12.1643-a
Publisher site
See Article on Publisher Site

Abstract

Report of a case A 59-year-old man presented with a 3-week history of painful, enlarging lesions on his abdomen that had developed after he sustained a pavement abrasion injury. Daily cleansing with hydrogen peroxide was of no benefit. The patient was a recovering alcoholic; his medical history was significant for hypertension, chronic obstructive pulmonary disease, and depression. His medications included albuterol, ipratropium bromide, and fluoxetine. He had no history of halogen ingestion or recent travel. A serologic test had been negative for human immunodeficiency virus infection 4 years earlier. Physical examination revealed 2 vegetating, erythematous, exudative plaques, measuring 9 × 9 and 3 × 7 cm in greatest dimension, on the abdomen. The borders were elevated, violaceous, and irregular but well-demarcated (Figure 1). The plaques were studded with smallpustules (Figure 2) and appeared to be focally eroded. There were a few isolated pustules near the plaques, and typical lesions of ecthyma were present on the hands. Regional lymph nodes were of normal size. The following laboratory parameters were within normal limits: complete blood cell count, serum electrolyte profile, and serum liver transaminase and albumin levels. A punch biopsy specimen (Figure 3) and cultures (aerobic/anaerobic bacterial, mycobacterial, and fungal) were obtained. Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload What is your diagnosis?

Journal

Archives of DermatologyAmerican Medical Association

Published: Dec 1, 2006

Keywords: abrasion,pustule

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