[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Citations 0
Off-Center Fold
May 2005

Necrotic Ulcer on the Thumb of a Teenager With Leukemia—Diagnosis

Arch Dermatol. 2005;141(5):633-638. doi:10.1001/archderm.141.5.633-h

Medium-power microscopy showed acral skin with a hemorrhagic crust and marked epidermal and dermal necrosis. No obvious vascular thrombosis was present. Closer inspection revealed numerous septate hyphae with acute angle branching, features that were accentuated with the periodic acid–Schiff and methenamine silver stains. Cultures of the bulla fluid, resected bowel, sputum, and bronchial lavage yielded Aspergillus flavus. Blood cultures remained negative for organisms throughout the patient’s hospital course. Despite aggressive treatment with amphotericin B and fluconazole, the patient’s condition deteriorated rapidly, and she died 3 days later.

First Page Preview View Large
First page PDF preview
First page PDF preview