case_images: PMC10627065_01
case_images: (a) The patient exhibited symmetrical whip-like lesions on the back and the shoulders accompanied by pruritus. (b) Significant improvement and disappearance of the skin lesions were observed following treatment with TCZ.
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case_images: The patient did not experience significant pain when pressing on these lymph nodes.Her upper limb muscle strength was slightly lower than normal, while the lower limb muscle strength was at normal levels.The liver can be palpable 1cm below the costal margin, and no other abnormalities were found on physical examination of the heart, lungs, and abdomen.The patient exhibited a diffuse red rash on the skin, accompanied by whip-like lesions present on the shoulder, back, chest, and abdomen regions (Figure 1). The lesions were accompanied by intense itching. Throughout the 4-week follow-up period, the patient remained afebrile and reported an absence of discomfort such as headache, fatigue, or sore throat. The skin rash and joint pain were completely resolved (Figure 1).
case_images: Histopathologic images of the patient's skin lesions (HE x 200).The arrow in the figure indicates the precise lesion of the patient.
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case_images: The superficial dermis exhibited infiltration of lymphocytes, a few eosinophils, and neutrophils around small blood vessels (Figure 2). 
case_images: Dynamic changes of inflammatory markers.
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case_images: On the 9th week of treatment, repeat testing showed the following levels: IL-6 2.89 pg/mL, SF 195.8 ng/mL, WBC 7.8x109/L, and CRP 20.01 mg/L (Table 1 and Figure 3).