26327988 Visualization

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