PMC8138254_01
Grade 3 tonsillar enlargements with ulcerated pus-filled lesions on both tonsils on hospital day 3 in a Treponema pallidum-infected woman with Sweet syndrome.
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F1
Physical examination findings were notable for a temperature of 37.9 C, bilateral cervical lymphadenopathy, grade 3 tonsillar enlargements with ulcerated pus-filled lesions on the right tonsil (Fig. 1), and multiple pseudovesicular, mammillated, edematous plaques on her neck, face, and extremities (Fig. 2).
Histopathology showing neutrophil-rich upper dermal infiltrate.
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F3
A skin biopsy specimen demonstrated a neutrophil-rich and acanthotic epidermis; a diffuse cellular infiltration of the upper dermis with a nodular tendency consisted of centrally located neutrophils, showing leukocytoclasia with admixed histiocytes and lymphocytes, plasma cells and eosinophils were absent; endothelial cell swelling and proliferation was noted but without extravasated red cells, fibrinoid necrosis of vessels, or microthrombi (Fig. 3).