[Skip to Navigation]
[Skip to Navigation Landing]
Views 1,290
Citations 0
JAMA Dermatology Clinicopathological Challenge
October 2017

Disseminated Erythematous Crusted and Pustular Plaques on the Trunk

Author Affiliations
  • 1Department of Dermatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
JAMA Dermatol. 2017;153(10):1049-1050. doi:10.1001/jamadermatol.2017.1071

A healthy woman in her 60s presented with multiple erythematous crusted plaques on her trunk that had appeared 4 weeks previously, sparing her limbs and facial region (Figure, A). She had a long-standing history of several outbreaks of skin lesions limited to both axillae and groin. Previous episodes had been successfully treated with various topical drugs that were administered by her primary care physician. No family history of similar lesions was recorded. Physical examination revealed multiple annular erythematous plaques surrounded by a peripheral crusted and pustular collarette on her trunk (Figure, B). No active lesions were present in her axillae, inframammary folds, or groin. After obtaining informed consent, 2 biopsy specimens were taken from the periphery of the lesion for hematoxylin-eosin stain and direct immunofluorescence (Figure, C and D). A skin swab specimen from a pustular lesion was taken for microbiological culture.