PMC8088410_01
Clinical presentation of the patient on admission. Scattered pustules over diffuse, symmetrical erythematous patches and plaques that arise predominantly on the lower back and upper thighs (A and B). The lesions coalesced into crusted erythematous plaques covered with larger pustules and lakes of pus over extensor surface of the left elbow (C) and inner upper left thigh (D).
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Several of the lesions had coalesced into crusted erythematous plaques covered with lakes of pus over extensor surfaces of elbows (Figure 1).
Histopathological findings of lesional skin biopsy showing intraepidermal spongiform pustule consisting of accumulated neutrophils in an acanthotic, hyperkeratotic and parakeratotic epidermis. The dermis showed a sparse perivascular mixed inflammatory infiltrate (x100, hematoxylin and eosin [H&E]).
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The dermis showed a sparse perivascular mixed inflammatory infiltrate (Figure 2).
Clinical presentation of the patient 21 days after the initial photographs were taken. Dramatic improvement of the lesions 2 weeks after the first infusion of infliximab and 3-week treatment with acitretin (A and B).
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Photographs of the patient taken on the day of the second infusion of infliximab are shown in Figure 3.