case_images: PMC10858749_01
case_images: Warm, poorly defined erythematous patches on both shins without tenderness. Asymmetric (left greater than right) erythema and swelling of the lower legs prior to (A) and following (B) the initiation of prednisone
case_images: cureus-0016-00000052114-i01.jpg
case_images: PMC10858749_01_cureus-0016-00000052114-i01.jpg
case_images: FIG1
case_images: Physical examination revealed warm, poorly demarcated erythematous patches on the bilateral shins without prominent tenderness (Figure 1A). He started an eight-day 40 mg prednisone taper for the pseudocellulitis, with which the swelling and erythema improved (Figure 1B). Compression stockings and a course of prednisone 10 mg daily for a week following each pemetrexed infusion helped mitigate the swelling and erythema that occurred after each infusion (typically beginning two to three days later); however, it did not completely resolve his symptoms (Figure 1B).
case_images: PMC10858749_02
case_images: lower extremity edema. Lower extremity edema, warmth, and a peau de orange appearance, along with ill-defined erythematous tender plaques extending from the foot to the right lower abdomen
case_images: cureus-0016-00000052114-i02.jpg
case_images: PMC10858749_02_cureus-0016-00000052114-i02.jpg
case_images: FIG2
case_images: At this time, physical examination revealed marked bilateral (right greater than left) lower extremity edema, warmth, and a peau de orange appearance, with ill-defined erythematous tender plaques extending from the foot to the right lower abdomen (Figure 2).
case_images: Histology of a punch biopsy . Histology reveals dermal edema with a sparse interstitial infiltrate of neutrophils and occasional eosinophils
case_images: cureus-0016-00000052114-i03.jpg
case_images: PMC10858749_02_cureus-0016-00000052114-i03.jpg
case_images: FIG3
case_images: A punch biopsy revealed dermal edema with a sparse interstitial infiltrate of neutrophils and occasional eosinophils (Figure 3).