PMC3336228_01
Skin vesiculobullous lesions on left leg.
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On physical examination, she presented vesiculobullous lesions (Figure 1) mostly located on her trunk and extremities, including palms and soles (Figure 2).
Skin lesions on left palm and on third finger.
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On physical examination, she presented vesiculobullous lesions (Figure 1) mostly located on her trunk and extremities, including palms and soles (Figure 2).
Metacarpal-phalangeal arthritis of the left hand.
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An asymmetric arthritis of her left elbow, wrist and metacarpophalangeal joints (Figure 3), right ankle, and first metatarsophalangeal joint was present.
Sagittal T2-weighted, gadolinium-enhanced NMR imaging demonstrates enhancing epidural collection ventrally compressing the thecal sac opposite the L5-S2 vertebrae. The L5-S1 disk space is partially obliterated and the bony end plates enhanced, reflecting discitis and osteomyelitis.
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