Multiple skin lesions - 1/11/2004
A 56-year-old white male was admitted to the hospital due to multiple skin lesions. In addition, he complained for dysuria and hematuria within the last month prior to his admission, with clinical characteristics compatible with urethritis or prostatitis. One month prior to his admission, pruritic skin lesions appeared, first on his back, and then spread to upper extremities trunk and finally to the lower extremities. His primary physician treated him with steroids per os but no improvement was achieved. During the last days prior to his admission the patient noticed an increase in the number of skin lesions, as well as seropurulent discharge from several of them. The patient did not report arthralgias, anorexia, or loss of weight. His past medical history included an idiopathic thrombocytopenic purpura episode 8 years ago, a cytomegalovirus "mononucleosis like" infection 1 year ago, and a urinary truck infection (not otherwise specified) six months ago.
Physical examination revealed multiple skin lesions with diameter ranging from 0,5 cm to 5 cm (Figures 1 and 2). Some lesions had a central crust, while others an erythematous halo. The lesions were in different shapes vesicles and pustules, coalescing in some areas. In some of the lesions, seropurulent discharge was present. No lymphadenopathy was found. The rest of the physical examination was normal.
