--- a +++ b/processing/MACCROBAT/26327988.txt @@ -0,0 +1,14 @@ +A 66 year old patient with a history of UC treated by mesalazine since 5 years consulted in July 2012 for a painful erythematous swelling of the back of the right hand. +The bacteriological samples were negative, the lesion was considered as an abscesses and the patient was treated with antibiotics and local antiseptics without improvement. +The evolution was characterized by the appearance of an erythematous vesiculobullous centrifugal expansion taking the whole back of the right hand treated several times by various antibiotics unsuccessfully. +Biopsy of this lesion was initially not specific. +In October 2012, the patient was hospitalized for fever and polyarthralgia in the context of impaired general condition. +He had a quiescent UC disease. +The skin examination found an erythematous plaque of 10 cm of diameter, with a raised border and vesicules, taking the back of the right hand and wrist (Figure 1). +There was also an infiltrated erythematous plaque on the right leg (Figure 2) and another topped with a large pustule at the left ankle (Figure 3). +In biology, there was a biological inflammatory syndrome and high leukocytosis with neutrophils. +Hepatic and renal functions were normal. +Skin biopsy showed at the edge of the back of the closet right hand ulcerated epidermis and the dermis infiltrate rich in neutrophils with leukocytoclastic vasculitis finding a PG (Figure 4). +Other biopsies taken at infiltrated erythematous plaques of the ankle showed a normal appearance of skin, edema of the superficial dermis based on an infiltrate rich in neutrophils without vasculitis confirming the diagnosis of SS (Figure 5). +Corticosteroid treatment was then started with prednisolone at a dose of 1mg/Kg/j. +The evolution was marked since day 7 of treatment by the desinfiltration of the plaques (Figure 6), the recovery of the general condition and disappearance of biological inflammatory syndrome.