Presenter: Scott Thomas DO, John Young MD, Angela Bohlke MD
Dermatology Program: Silver Falls Dermatology/Western University of Health Sciences
Program Director: John Young, MD
Submitted on: December 4, 2013
CHIEF COMPLAINT: Itchy bumps on body
CLINICAL HISTORY: A 53-year-old male presented to the clinic with complaints of itchy bumps on his body, which had been present for approximately a year and a half. He reported no associated systemic symptoms, recent travel, known exposure to tuberculosis, or prior occurrences of similar symptoms. The patient denied having received any previous treatment for his condition. His social history was unremarkable, and his past medical history was significant only for idiopathic myelofibrosis, for which he had recently started chemotherapy one week prior.
PHYSICAL EXAM:
On physical exam, the patient exhibited scattered erythematous papules, nodules, and plaques on his back, chest, and extremities.
LABORATORY TESTS: N/A
DERMATOHISTOPATHOLOGY:
A punch biopsy was performed of an erythematous plaque on the patient’s left posterior shoulder. Pathology results revealed a superficial and deep perivascular and interstitial inflammatory infiltrate composed of lymphocytes, neutrophils, bands, and immature erythrocytes.
DIFFERENTIAL DIAGNOSIS:
1. Sweet’s Syndrome
2. Wells Syndrome
3. Leukemia Cutis
4. Cutaneous Extramedullary Hematopoiesis
5. Urticaria
