Localized pustules, 4-5 years long. Only arms. | Figure 1

Clinical Case Summary

Initial Presentation

Localized pustules, 4-5 years long. Only arms.

Patient History

• 33-year-old nurse in ICU unit
• History of malaria and Lyme disease (medical missions)
• Began to have small singular eruptions on arms only, about 5 years ago
• Painful, but not pruritic until healing stage (up to 2 weeks)
• Can go months without a new breakout
• Fully vaccinated (flu and COVID with Pfizer boosters)
• No known environmental exposure
• No other symptoms, pertinent history, allergies, or known immune disease.

Posted with permission.

Update

Update 1

• STD panels negative.
• Declined puncture testing.
• A course of clobetasol propionate has been started and has shown marked improvement.

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