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Arch Dermatol. 2004;140:479-484.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Bullous pyoderma gangrenosum (PG).

MICROSCOPIC FINDINGS, LABORATORY FINDINGS, AND CLINICAL COURSE

The skin biopsy specimen showed an extremely dense and extensive inflammatory infiltrate occupying all of the dermis except for the papillary dermis, which was grossly edematous. The overlying epidermis contained a scattering of lymphocytes and foci of spongiosis with cell degeneration. The dermal infiltrate consisted of a dense mass of neutrophils, most of which appeared to have a normal morphological appearance. Hemorrhage and edema were also present, and in the relatively spared areas, small blood vessels showed very marked endothelial swelling. A definite leukemic infiltrate was not identified. The microscopic features were in keeping with a primary neutrophilic dermatosis, such as PG or Sweet syndrome. The features seemed most consistent with PG.

Bacterial culture was obtained, and no organisms were identified. The histologic features and rapid deterioration supported the diagnosis of bullous PG. The patient was immediately treated with three 500-mg pulses of intravenous methylprednisolone, followed by oral prednisolone at . . . [Full Text of this Article]

DISCUSSION

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Arch Dermatol. 2004;140(4):479-484.
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