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October 1991

Vesiculopustules of the Thighs and Abdomen

Author Affiliations

Texas Tech University Health Sciences Center, Lubbock

Arch Dermatol. 1991;127(10):1571-1572. doi:10.1001/archderm.1991.01680090135019

REPORT OF A CASE  A 31-year-old woman was referred to the dermatology clinic with a 2-month history of a vesiculopustular eruption. The lesions were infrequently pruritic. She had been treated with erythromycin base (PCE), 2% mupirocin ointment (Bactroban), methylprednisolone (Medrol), and intramuscular triamcinolone acetonide (Kenalog), all without appreciable effect. She denied any previous dermatologic problems, systemic symptoms, chemical exposure, or travel. Her medications included oral contraceptives and weekly injections for her allergy.Dermatologic examination revealed discrete erythematous vesicles and pustules involving the anterior aspect of her thighs, lower abdomen, neck, and arms (Figs 1 and 2). No scaling or crusting was observed. The remainder of her skin was normal.A hemogram, reticulocyte count, and chemistry profile all showed normal results. Routine bacterial cultures of intact vesicles revealed no pathogens.Histopathologic analysis showed a subcorneal pustule (Fig 3) filled with numerous neutrophils and serous exudate (Fig 4). The basal cell layer

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