case_images: PMC11284048_01
case_images: (A-D) Multiple umbilicated papules and nodules with a central keratotic crust on the patient's trunk and limbs.
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case_images: f1
case_images: These lesions initially presented as umbilicated papules, but progressed to ulcerated plaques, predominantly on the trunk and limbs ( Figure 1 ).
case_images: (A, B) Lesional skin biopsy showing a cup-shaped depression plugged with necrotic inflammatory debris. (C) Van Gieson staining showing elimination of fibrous tissue through the dermis into the epidermis. (A) x40. (B) x200. (C) x400.
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case_images: f2
case_images: Elastica van Gieson staining showed fibrous tissue being ejected through the epidermis ( Figure 2 ).
case_images: (A-C) Residual hyperpigmented lesions, atrophic scars, and a few superficial erosions on the patient's trunk and limbs after baricitinib treatment.
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case_images: f3
case_images: Department of Dermatology on December 28, 2023. During the physical examination, cup-like ulcerated lesions on her trunk and limbs were noted, along with multiple scar formations ( Figure 3 ).
case_images: (A) Comparison of the total IgE levels before and after treatment. (B) Comparison of the eosinophil counts before and after treatment. (C) Comparison of the Numeric Rating Scale (NRS) scores before and after treatment.
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case_images: f4
case_images: The NRS score increased to 4 ( Figure 4 ).