A 48-year-old woman presented with a 2-year history of diffuse, tender, erythematous pustules and papules. The eruption occurred in groups and persisted for several weeks during each episode before resolving spontaneously. These outbreaks were mostly confined to the upper part of the trunk and the extremities. The rash was accompanied by arthralgias, primarily involving the shoulders, as well as swelling of the wrists and fingers. The patient's medical history was notable for pancreatitis, a cholecystectomy, an appendectomy, a hysterectomy, ileojejunal bypass surgery, and bladder and rectum repair.