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Hemorrhagic Bullae on the Hands—Quiz Case
Jack J. Liu, BS;
Melvin W. Chiu, MD
David Geffen School of Medicine at UCLA, Los Angeles, California
Arch Dermatol. 2008;144(2):255-260.
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REPORT OF A CASE
A 66-year-old man with hypertension presented with painful, raised erythematous lesions on the dorsal surface of both hands for 2 days. The lesions were preceded by a 1-week history of low-grade fevers, sore throat, and back stiffness. He was treated with methylprednisolone for 1 day by his primary care physician. The patient denied any other systemic symptoms or areas of affected skin. There was no exposure to new chemicals, medications, or detergents.
Physical examination revealed violaceous, hemorrhagic bullae on the dorsal aspects of both hands (Figure 1). They were raised, firm, and mildly tender. A skin biopsy specimen of the dorsal surface of the right hand was obtained (Figure 2 and Figure 3).
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What is your diagnosis?
SECTION EDITOR: MICHAEL E. MING, MD, MSCE; ASSISTANT SECTION EDITORS: CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; JACQUELINE M. JUNKINS-HOPKINS, MD; VINCENT LIU, MD; KARLA S. ROSENMAN, MD
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Hemorrhagic Bullae on the Hands—Diagnosis
Arch Dermatol. 2008;144(2):255-260.
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