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A 65 year old woman with a history that dates back in her teens of multiple pustules affecting both axilla. She has had numerous incision and drainage, and has taken multiple antibiotics which only gives partial relief. The pustules sometimes appear following shaving but most of the time the appearance is spontaneous, especially in hot weather conditions. Her ERS is 115mm/hr. Positive family history: daughter and first cousin (female). I am thinking of complement deficiency. Have ordered for C4. What are your thoughts?
Additional cases:
30 years old male patient: came to the outpatient clinic with nodule, pustules and hypotrophic skin on scalp since 1 year ago. History of the same clinical condition admitted 5 years ago. Complaint only minimal itching. View Case
Ideas? 55yo Burmese man: presents with 2-day history of painful pustules/papules/vesicles on face and chest and axilla, in addition to painful and swollen left temple. Is tachycardic, febrile, all lesions very tender to touch. No capacity for labs or biopsy. Thoughts about the painful pustules?? View Case
24F, trisomy 8, with a 2-week history of a progressive, painful purpuric eruption on bilateral feet. No pustules or vesicles. My clinical dx is Osler nodes, LCV, infection. View Case
86-year-old female: with history of hypertension, diabetes, anemia, HLD, and vitamin D deficiency presents with pustules after an ant bite. Are these pustules normal? View Case
Trending cases: A 52-year-old man presented with chest pain radiating to the left shoulder and neck, associated with dyspnea. View Case
Conclusion
Feel free to share your thoughts or insights on the cases discussed.