A 53-year-old male with pruritic red papules

Presenter: Scott Thomas DO, John Young MD, Angela Bohlke MD
Dermatology Program: Silver Falls Dermatology/Western University of Health Sciences
Program Director: John Young, MD
Submitted on: Dec 4, 2013

CHIEF COMPLAINT:  A 53-year-old male presented to the clinic with complaints of itchy bumps on his body.


Signs and symptoms:  Itchy bumps on his body have been present for about a year and a half. He denied any associated systemic symptoms, preceding travel, known tuberculosis exposure, previous treatment, or previous occurrence.

Previous Treatment:  Denied

Other information:  His social history was benign and his past medical history was significant only for idiopathic myelofibrosis for which he had started chemotherapy one week prior.


On physical exam the patient exhibited scattered erythematous papules, nodules, and plaques on his back, chest, and extremities (Figure 1).

Figure 1



A punch biopsy was performed of an erythematous plaque on the patient’s left posterior shoulder. Pathology results revealed a superficial and deep perivascular and interstitial inflammatory infiltrate composed of lymphocytes, neutrophils, bands, and immature erythrocytes (Figures 2 and 3).

Figure 2
Figure 3


1.   Sweet’s Syndrome
2.   Wells Syndrome
3.   Leukemia Cutis
4.   Cutaneous Extramedullary Hematopoiesis
5.   Urticaria

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