https://orcid.org/0000-0002-8108-962X
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William A Wright, Erin Kamp, Esra Musbahi, Michael Koenig, Mara Quante, Emma Topham, Erythematous tender nodules on the legs with oily exudate, Clinical and Experimental Dermatology, Volume 48, Issue 6, June 2023, Pages 714–716, https://doi.org/10.1093/ced/llad065
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Extract
Clinical findings
A 70-year-old woman presented to her general practitioner with multiple tender erythematous nodules of her lower limbs in December 2021. She was systemically well with no additional symptoms and had no preceding illness. She denied excessive alcohol intake. She was initially treated with oral antibiotics for suspected infected insect bites followed by an admission for suspected cellulitis. Blood tests revealed a neutrophilia with elevated C-reactive protein. Antibiotics were discontinued after 2 weeks with only mild clinical improvement and she was referred to Dermatology.
On assessment she was noted to have multiple tender erythematous subcutaneous nodules on her legs bilaterally (Figure 1). Some of these had broken down and were discharging an oily substance. Blood tests, including antinuclear antibodies, antineutrophil cytoplasmic antibodies, angiotensin-converting enzyme, complement, T-spot and antistreptolysin O titres were unremarkable except for a normocytic anaemia. A punch biopsy was taken from a lesion on her right thigh. Skin culture, including extended low temperature culture, was negative.
