PMC4641343_01
Day 3 of hospital admission, before initiation of systemic steroid therapy. Numerous small studded pustules on an erythematous background with numerous erythematous macules and papules coalescing into plaques are noted in various body parts
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Fig1
Physical examination revealed numerous small studded pustules on an erythematous background on the forehead, frontal scalp, cheeks, trunk, upper and lower extremities, and axilla, with numerous erythematous macules and papules coalescing into plaques noted on the back, trunk, and extremities (Fig. 1).
Histopathology of skin biopsy revealing spongiotic epidermis with focal parakeratosis, exocytosis, and spongiotic vesicles, along with papillary dermal edema, superficial dermal perivascular inflammatory infiltrate, and mixed dermal interstitial inflammation with eosinophils (H&E, x10). The arrow points to the "papillary dermal edema and superficial dermal perivascular inflammatory infiltrate"
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Fig2
Histopathological examination of the skin punch biopsy revealed sub-corneal and intraepidermal pustules, widespread spongiosis, and neutrophil infiltration around the vessels in the papillary dermis:findings consistent with acute generalized exanthematous pustulosis (Fig. 2).
Day 4 of hospital admission, after initiation of systemic steroid therapy. Significant regression of skin eruptions noted
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Fig3
Within 24 h, the skin rash had regressed significantly (Fig. 3).