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A 23-year-old white woman presented with a 2-month history of a pyoderma gangrenosum–like ulcer in the right postauricular region. The cutaneous lesion had initially started as a pustule that was associated with local pain, subfebrile temperature, night sweats, and spontaneous perforation with a whitish discharge 2 weeks after the disease onset. Necrectomy was performed, and antibiotics (clindamycin, amoxicillin and clavulanate potassium [co-amoxiclav], and azithromycin) were administered intravenously in an outpatient clinic, without success.
Kovac L, Bumber B, Bilic M, Hutinec Z, Topic I. Pathology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2008;134(10):1116. doi:10.1001/archotol.134.10.1116