Multiple friable nodules on back

Presenter: Jackie Levin D.O., Ralph Fiore D.O., and Ellecia Cook D.O.
Dermatology Program: Largo Medical Center
Program Director: Richard Miller
Submitted on: Jan 6, 2012

CHIEF COMPLAINT:  Bumps on back

CLINICAL HISTORY:

Signs and symptoms:  Present x 2 years. Located from mid to lower back. Painful, draining, and worsening. Recently incised and drained by PCP.

Previous Treatment:  Incision and drainage, oral antiobiotics, and topical antibiotics.

Other information:  Past medical history significant for hidradenitis suppurativa of the axillae, inguinal, and perianal region in which surgical excision was performed.

PHYSICAL EXAM:

Multiple friable, violaceous nodules located from the lower thoracic to upper lumbar region

 

Figure 1. Back

LABORATORY TESTS:

Bacterial culture negative.

DERMATOHISTOPATHOLOGY:

Figure 2. HE Low Power

 

Figure 3. HE High Power

DIFFERENTIAL DIAGNOSIS:

1.   Pyogenic Granuloma
2.   Neutrophilic Dermatosis
3.   Hidradenitis Suppurativa
4.   Staphyloccocal Furunculosis
5.   Cutaneous Crohn’s


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