case_images: PMC3937488_01
case_images: Skin-colored nodules over the knuckles
case_images: IDOJ-5-48-g001.jpg
case_images: PMC3937488_01_IDOJ-5-48-g001.jpg
case_images: F1
case_images: A 50-year-old male presented with firm skin-colored and erythematous nodules over the knuckles, elbows, buttocks, knees, and lower legs which gradually increased in size in since 3 years duration [Figure 1].
case_images: Neutrophilic vasculitis with leucocytoclasia (H and E, x400)
case_images: IDOJ-5-48-g002.jpg
case_images: PMC3937488_01_IDOJ-5-48-g002.jpg
case_images: F2
case_images: Biopsy of the nodules of the knuckles showed focal parakeratosis and mild spongiosis in the epidermis, perivascular neutrophilic infiltrate in the dermis, neutrophils in the vessel wall and leukocytoclasia [Figure 2].
case_images: Linear IgA deposits in the basement membrane zone
case_images: IDOJ-5-48-g003.jpg
case_images: PMC3937488_01_IDOJ-5-48-g003.jpg
case_images: F3
case_images: Immunofluorescence showed linear IgA deposits in the basement membrane zone and weak granular perivascular C3 and fibrinogen deposits [Figure 3].
case_images: Dermal papillary microabscess (H and E, x400)
case_images: IDOJ-5-48-g004.jpg
case_images: PMC3937488_01_IDOJ-5-48-g004.jpg
case_images: F4
case_images: Biopsy of the vesicular lesions were consistent with dermatitis herpetiformis [Figure 4].