The dermatology department was asked to consult for a man in his 60s who had been hospitalized for 2 days with a 1-week history of painful lesions on the dorsal aspect of the right hand. He described the initial lesions as pustules that subsequently ulcerated. Treatment prior to consultation included trimethoprim sulfa, which had no effect on the lesions. He did not have a history of inflammatory bowel disease or other inflammatory disease, and he denied associated fever, gastrointestinal tract symptoms, recent infections, or any medication intake.
Altman K, Hinshaw MA. Ulcerating Pustules. JAMA Dermatol. 2014;150(8):897-898. doi:10.1001/jamadermatol.2014.202