From the Outside Looking In

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Presentation transcript:

From the Outside Looking In Yasbanoo Moayedi, MD, Paul E. Bunce, MD, Shachar Sade, MD, Danny Ghazarian, MD, Wayne L. Gold, MD The American Journal of Medicine Volume 125, Issue 5, Pages 457-460 (May 2012) DOI: 10.1016/j.amjmed.2011.10.021 Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 1 Skin lesions in a 41-year-old man with T-cell-rich B-cell lymphoma. A: Large hemorrhagic bulla on the right leg with an advancing border of cutaneous necrosis, consistent with ecthyma gangrenosum. A lesion at an earlier stage of development is seen to the right of the bulla. B: Lesion on the right lower abdominal wall demonstrating a central hemorrhagic bulla with surrounding necrosis and erythema. The American Journal of Medicine 2012 125, 457-460DOI: (10.1016/j.amjmed.2011.10.021) Copyright © 2012 Elsevier Inc. Terms and Conditions

Figure 2 Skin biopsy showing a medium-caliber vein within the mid-dermis (400× magnification). A: Hematoxylin and eosin stain showing neutrophilic destruction of the vessel wall with associated fibrinoid necrosis. Vascular occlusion by a luminal thrombus also is evident. B: Gram stain showing numerous Gram-negative bacilli within the vessel wall infiltrating into the dermis. The American Journal of Medicine 2012 125, 457-460DOI: (10.1016/j.amjmed.2011.10.021) Copyright © 2012 Elsevier Inc. Terms and Conditions