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July 1995

Ecthymalike Lesions on the Leg of an Immunocompromised Patient

Author Affiliations

Harvard Medical School, Boston, Mass

Arch Dermatol. 1995;131(7):835-836. doi:10.1001/archderm.1995.01690190089018

REPORT OF A CASE  A 23-year-old woman diagnosed with acute myelogenous leukemia presented after her third cycle of chemotherapy. Two weeks earlier, she had been receiving mezlocillin and gentamicin at home for fever and neutropenia. About 5 days before admission, she noted two pruritic red papules on her leg secondary to what she thought were insect bites. On the day of admission, the patient was increasingly febrile and hypotensive, and the skin lesions had progressed.Physical examination revealed two 1-cm exquisitely tender, erythematous plaques over the left anterior tibia with central eschar (Figure 1). No other lesions were noted, and no nodes were palpable. The rest of the physical examination was unremarkable, except for herpetic lesions around the nares. A skin biopsy specimen of the left lower extremity lesion was obtained (Figure 2), and prophylactic antimicrobial therapy was started.Figure 1.Figure 2.Ecthymalike Lesions on the Leg of an

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