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A 43-year-old woman was hospitalised with 21 days of fever, severe low back pain and 10 days of painful skin lesions involving both knees (panel A and B) (figure 1) in succession. The lesions emerged as erythema, then blistered and ulcerated rapidly with a necrolytic, undermined violaceous border that did not respond to antimicrobial therapy. She had an 8-year history of poorly controlled ulcerative colitis (UC). An exacerbation of bloody diarrhoea occurred 2 months ago. Laboratory testing revealed a C-reactive protein level of 16.4 mg/dL (reference value, <0.8), while antinuclear …
Footnotes
Handling editor Josef S Smolen
Contributors LH, YG and XS were involved in the management of the patient. LH and YG drafted the manuscript which was finalised by XS.
Funding National High Level Hospital Clinical Research Funding (2022-NHLHCRF-YS-02-05).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.