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March 1985

Vesiculopustular Eruption in a Patient With Ulcerative Colitis

Author Affiliations

University of Louisville (Ky) School of Medicine (Dr Callen); University of Michigan Medical School, Ann Arbor (Dr Woo)

Arch Dermatol. 1985;121(3):399-400. doi:10.1001/archderm.1985.01660030121033

REPORT OF A CASE  A 37-year-old woman had noted an increased frequency of stools, diarrhea, and occasional hematochezia at the age of 33 years. A diagnosis of ulcerative colitis with only distal involvement was made, and she was treated with oral sulfasalazine (Azulfidine) (1 g four times daily), prednisone (5 mg twice daily), and cortisone enemas as needed. This led to temporary control of her colitis. In December 1974, the patient experienced recurrent shaking chills and a temperature of 39.4 °C. Extensive evaluation failed to reveal an infectious cause, and although the ulcerative proctitis was moderately active, it was not felt to be related to the fever. The only abnormal laboratory results were elevated lactic dehydrogenase, alkaline phosphatase, and serum glutamicoxaloacetic transaminase levels. A liver biopsy specimen in December 1974 revealed a granulomatous hepatitis, but no organisms grew in the culture. Because of continued fever and hepatic granulomas, the sulfasalazine

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