Clinical Images

Skin Lesions With Leukocytosis

Adapted from article by Harris and Henderson in JGIM Feb, 2011 

 A 29-year-old Hispanic man was admitted to the hospital with fever, cough, sore throat, and red, tender leg nodules suggestive of erythema nodosum (Fig 1). The white blood cell count was 35,000.

Several days later, annular plaques and pustules developed on his face, neck, and forearms (Fig 2 and ​3). He had leukocytosis. A skin biopsy of the face showed neutrophilic dermatitis, sparing the epidermis, without evidence of bacterial infection or vasculitis.

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