Peer Reviewed
Dermatology clinic

Pustular ulcer with a blistering border

Steven Kossard
Abstract
A woman develops a rapidly expanding necrotic ulcer over her ankle. What is the cause and how can it be treated?
Key Points
    Case history

    Over a three-week period, a 43-year-old woman developed a rapidly expanding necrotic ulcer over her right medial ankle. The ulcer had a pustular and haemorrhagic base and a peripheral dusky blistering edge. Cultures for bacteria and fungi were negative. A skin biopsy from the edge of the lesion showed sheets of neutrophils undergoing leucocytoclasis and filling the dermis. The patient had a known history of Crohn’s disease.

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