case_images: PMC10067444_01
case_images: (A and B) Diffuse pruritic erythematous eruptions with nonfollicular pinhead-sized pustules (C) Perioral erosion and pus on the mucosal surface.
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case_images: Morphological features included oral and vulval mucosal inflammation, erosion with pus on the mucosal surface, diffuse pruritic erythematous eruptions with nonfollicular pinhead-sized pustules on the neck, trunk, and both upper extremities, along with purpura on the lower extremities (Figure 1).
case_images: Histopathology showing subcorneal pustules containing neutrophils on stratum corneum, papillary edema and perivascular infiltrate of lymphocytes on the superficial dermis ((A and B) for erythematous lesions); Skin biopsy showing basketweave stratum corneum with subcorneal pustules containing neutrophils, subepidermal and perivascular infiltrate of abundant lymphocytes and a small number of neutrophils and eosinophils on the superficial dermis ((C and D) for pustular lesions) (hematoxylineosin-saffron stain, original magnification x10, 2A and 2C: x20, 2B:x40, 2D).
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case_images: A skin biopsy revealed subcorneal pustules with epidermal spongiosis and perivascular inflammation of lymphocytes and eosinophils in the upper dermis and papillary edema (Figure 2). 
case_images: (A) On her hospital day 1: Just admission to hospital; (B) On her hospital day 14: After methylprednisolone (80 mg/4 days, 60 mg/4 days, 40 mg/4 days, ivgtt) treatment; (C) On her hospital day 16: Decreased dose to 32mg (po); (D) On her hospital day 24: After methylprednisolone (80 mg/10 days) and IVIG (10g/5 days); (E) On her hospital day 26: Decreased dose to 60 mg(ivgtt); (F) On her hospital day 34: After methylprednisolone (60 mg/5 days) and IVIG (10g/5 days). (G) On her hospital day 52: After methylprednisolone (60/40 mg 7 days) and discharged home from the hospital on a regimen of oral methylprednisolone (60 mg on odd days and 40 mg on even days).
case_images: IDR-16-1705-g0003.jpg
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case_images: We proceeded cautiously with the withdrawal of the glucocorticoid according to our clinical observations (Figure 3).