PMC5797804_01
Multiple purulent erythematous interconnecting plaques, some boggy with dried, yellow crust on the scalp.
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F1
On evaluation, he had bilateral lower abdominal tenderness in addition to multiple erythematous interconnecting plaques, some boggy with dried yellow crust on the frontal, parietal, and occipital scalp with scant purulent drainage (Figure 1).
Colonoscopy showing (A) pseudopolyps in the descending colon and (B) nonbleeding ulcerated mucosa in the rectum.
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F2
Colonoscopy disclosed a diffuse area of severely friable mucosa with contact bleeding and extensive polyps, most likely representing inflammatory pseudopolyps in the descending colon along with discontinuous areas of nonbleeding ulcerated mucosa in the rectum (Figure 2).
Descending colonic mucosa biopsy showing chronic active colitis. There is a single dilated crypt expanded with a neutrophilic inflammatory infiltrate or crypt abscess (arrow). (A) 20x magnification. (B) 40x magnification.
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F3
Descending colon biopsy showed chronic active colitis and a single dilated crypt expanded with a neutrophilic inflammatory infiltrate (crypt abscess; Figure 3).
Scalp biopsy revealing ulceration of the overlying epithelium with inflamed granulation tissue and fibrinopurulent debris (black arrow), obliteration of the hair follicles and the sebaceous glands, and squamous epithelium with superficial neutrophilic inflammatory infiltrate (red arrow). Within the dermis there is infiltrate of macrophages, plasma cells, lymphocytes, and neutrophils. (A) 20x magnification. (B) 40x magnification.
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F4
Scalp biopsy revealed epidermoid inclusion cysts, ruptured and inflamed, with granulation tissue and chronic inflammatory cell infiltration with no dysplasia or malignancy, indicative of dissecting cellulitis (Figure 4).