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. 2018 Aug 24:6:2324709618796659.
doi: 10.1177/2324709618796659. eCollection 2018 Jan-Dec.

Erythema Sweetobullosum: A Reactive Cutaneous Manifestation of Coccidioidomycosis

Hisham Abukamleh  1 , Arash Heidari  1 , Greti Petersen  1 , Piruthiviraj Natarajan  1 , Gian Yakoub  1 , Everardo Cobos  1 , Royce Johnson  1
Affiliations

Erythema Sweetobullosum: A Reactive Cutaneous Manifestation of Coccidioidomycosis

Hisham Abukamleh et al. J Investig Med High Impact Case Rep. .

Abstract

Reactive cutaneous coccidioidal skin manifestations are commonly noticed during the early stage of coccidioidomycosis. These skin lesions are devoid of any active coccidioidal organism, and the immune trigger mechanisms are not elucidated. We describe 6 cases of unusual reactive cutaneous coccidioidal manifestation, characterized by painful vesiculobullous lesions known as erythema sweetobullosum. The biopsy of the lesions revealed neutrophilic dermatosis with inflammatory cells resulting in a cleft and elevation of the most superficial layer of the skin forming a bulla. The reactive cutaneous lesion is self-limited and requires no specific therapy.

Keywords: coccidioidomycosis; cutaneous manifestation; erythema sweetobullosum; noninfectious.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Drained bullous lesions on the right leg.
Figure 2.
Figure 2.
H&E at 10X magnification. DE, dermal edema; LHC, lymphohistiocytic inflammatory cells.
Figure 3.
Figure 3.
Bullous lesions on the forearm with raised plaques.
Figure 4.
Figure 4.
Vesicles and bullous lesion on the arm.
Figure 5.
Figure 5.
H&E at 20X magnification. GIN, granulomatous inflammatory cells.
Figure 6.
Figure 6.
Vesiculo-bullous lesion on the bilateral forearms.
Figure 7.
Figure 7.
H&E at 20X magnification. GIN, granulomatous inflammatory cells.
Figure 8.
Figure 8.
Vesiculo-bullous lesions on the arm.
Figure 9.
Figure 9.
H&E at 20X magnification. VS, vesiculated subepidermal layer.
Figure 10.
Figure 10.
Bilateral crusted bullous lesion the leg and knee.
Figure 11.
Figure 11.
H&E at 20X magnification. VL, vesiculated layer; SE, subepidermal edema.
See this image and copyright information in PMC

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