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K. Mahmood, L. Nemazee, A rare cause of florid, haemorrhagic blisters in two siblings, Clinical and Experimental Dermatology, Volume 39, Issue 5, 1 July 2014, Pages 658–660, https://doi.org/10.1111/ced.12334
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Extract
Conflict of interest: the authors declare that they have no conflicts of interest.
Clinical findings
An 8‐year‐old boy was admitted under the joint care of the paediatricians and maxillofacial surgeons with a 9‐day history of a subcutaneous mass. On physical examination, there was a firm, tender, subcutaneous lump, 30 mm in size, with redness and swelling of the overlying skin. There was a central, tense, haemorrhagic blister, which ruptured, leaving an ulcer (Fig. 1a). The submental lymph nodes were tender and enlarged. The patient felt unwell, and had a temperature of 39.6°C, and a heart rate of 122 beats/min. There was no history of preceding trauma. The C‐reactive protein level was raised at 23 mg/L (normal < 10 mg/L). A provisional diagnosis of an infected sebaceous cyst was made, and intravenous benzylpenicillin was started. However, there was no improvement after a week on antibiotics, and in the meantime, similar but smaller lesions appeared at the left corner of the patient's mouth and on the dorsum of his left hand (Fig. 1b).
