PMC6362748_01
(a and b) Multiple erythematous papules over the face. (c) Multiple erythematous papules and edematous urticarial plaques over the back. (d) Purpuric lesion over the thenar aspect of right palm
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F1
On cutaneous examination, multiple erythematous papules, edematous urticarial plaques and purpuric lesions of varying sizes were present over the face, neck, trunk, upper, and lower extremities [Figure 1a-d].
(a) Moderately dense perivascular and interstitial infiltrate of lymphocytes, eosinophils, and neutrophils with spongiosis in the superficial and mid-dermis. (Hand E staining, x10). (b) Interstitial infiltrate of many mature eosinophils intermixed with neutrophilswith areas of leukocytoclasia without vasculitis (Hand E staining, x40)
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F2
Sweet's syndrome. Skin biopsy with hematoxylin and eosin stain found wedge-shaped moderately dense perivascular and interstitial infiltrate of many mature eosinophils intermixed with neutrophils in the superficial and mid-dermis with areas of leukocytoclasia without any evidence of vasculitis [Figure 2a and b].
(a and b) Resolution of facial lesions after treatment. (c) Significant decrease in the number and size of lesions after treatment. (d) Clearance of palmar lesion after treatment
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F3
Simultaneously, the intensity of pruritus decreased with significant reduction in the number and size of lesions during each eruption [Figure 3a-d].