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JAMA Dermatology Clinicopathological Challenge
August 2014

Ulcerating Pustules

Author Affiliations
  • 1Department of Dermatology, University of Wisconsin, Madison, Hospital and Clinics, Madison
  • 2Dermpath Diagnostics, Troy and Associates, Brookfield, Wisconsin
JAMA Dermatol. 2014;150(8):897-898. doi:10.1001/jamadermatol.2014.202

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.