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February 1994

Ulcerative Lesions in a Gardener

Author Affiliations

University of South Florida College of Medicine, Tampa (Dr Saff); North Ridge Medical Center, Oakland Park, Fla (Dr Poulos); University of Florida, Gainesville (Dr Unis)

Arch Dermatol. 1994;130(2):243-244. doi:10.1001/archderm.1994.01690020111018

REPORT OF A CASE  A 57-year-old woman presented with a 4-day history of a painful ulcerative erythematous lesion on the medial aspect of her right upper thigh. She denied any associated fever, chills, recent trauma, or bites but reported working in her garden several times in the few weeks before the onset of the lesions. Her history was significant for diet-controlled non—insulin-dependent diabetes and idiopathic cutaneous leukocytoclastic vasculitis that responded well to a short course of prednisone 3 years earlier. She received no medications since then.The physical examination showed her to be afebrile. On the aforementioned thigh was a moderately tender bullous lesion (2.2×3.5 cm). The lesion displayed central necrosis, early ulceration, and surrounding bluishred erythema and induration (diameter, 6 to 7 cm)(Figure 1). Two crusted pustular lesions (4 to 5 mm) with surrounding erythema were noted on her left upper arm. There was no palpable adenopathy. The

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