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case_images: (A and B) Follicular pustules and desquamative scales with a background of erythema over the axilla and breast. (C) Eroded pustules over background of erythematous edematous plaque over the breast. (D) Same as A but over the lateral side of the upper back.
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case_images: Upon physical examination, the patient was vitally and clinically stable Dermatological assessment revealed numerous non follicular pustules and desquamative scales on top of erythematous and edematous plaques distributed from the upper chest to the upper arms and lateral aspects of the trunk bilaterally (Figure 1).
case_images: (A) At 40x, this punch biopsy clearly demonstrates an epidermal erosion, subcorneal and intraepidermal pustule. In the dermis there is evidence of perivascular infiltrate. (B) At 100x, Subcorneal and intraepidermal neutrophilic infiltrate, spongiosis, and perivascular inflammation is seen with dermal edema (upper left). (C) At 200x, an intradermal neutrophilic pustule is seen, with vacuolar interface dermatitis. A significant number of eosinophils can be seen. (D) At 200x, within the superficial dermis, the perivascular lymphoplasmacytic is appreciated along with scattered eosinophils and neutrophils.
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case_images: A skin biopsy from a lesion on the right lower abdomen was performed, which, in conjunction with the clinical presentation, was suggestive of AGEP (Figure 2).
case_images: (A and B) Post inflammatory hyperpigmented macules and patches over the Upper limb and lateral side of the trunk.
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case_images: Residual post-inflammatory hyperpigmentation was noted on both upper extremities, with no active lesions observed (Figure 3).