case_images: PMC3884177_01
case_images: Clinical and histopathological features of case 1. a An 1.5 x 1.5 cm ulcer on the lateral corner of the left eye with a necrotic and fibrinoid surface. b Histopathological examination of a biopsy specimen showed a dense, mixed-cell, dermal infiltrate with numerous neutrophilic granulocytes and some macrophages. c Less necrotic and clean base as well as less inflammatory borders after 2 weeks of systemic corticosteroid therapy.
case_images: cde-0005-0295-g01.jpg
case_images: PMC3884177_01_cde-0005-0295-g01.jpg
case_images: F1
case_images: Initial physical examination in our outpatient department showed a deep ulcer on the lateral corner of the left eye, 1.5 x 1.5 cm in size, with a necrotic and fibrinoid surface (fig. 1a). Histology from a skin biopsy taken from the edge of the ulcer showed a dense, mixed-cell, dermal infiltrate with numerous neutrophilic granulocytes and some macrophages (fig. 1b). Within 2 weeks, the ulcer was reduced in size, showed a clean base without necrotic debris, and the border was less inflamed (fig. 1c).
case_images: PMC3884177_02
case_images: Clinical and histopathological features of case 2. a Painful ulcer with violaceous, undermined borders on the left part of the lower lip. b Stable remission after 4 months of treatment. c After 48 h, all 7 testing sites showed erythematous papules up to 3 mm in diameter.
case_images: cde-0005-0295-g02.jpg
case_images: PMC3884177_02_cde-0005-0295-g02.jpg
case_images: F2
case_images: Physical examination showed an ulcer with violaceous undermined borders on the left part of the lower lip (fig. 2a). After 48 h at all 7 testing sites, erythematous papules up to 3 mm in diameter were visible (fig. 2c). Topical treatment with a triamcinolone acetonide-containing ointment significantly improved healing, and the patient suffered no relapses afterwards (fig. 2b).