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A 48-year-old woman presented with a 2-year history of diffuse, tender, erythematous pustules and papules. The eruption occurred in groups and persisted for several weeks during each episode before resolving spontaneously. These outbreaks were mostly confined to the upper part of the trunk and the extremities. The rash was accompanied by arthralgias, primarily involving the shoulders, as well as swelling of the wrists and fingers. The patient's medical history was notable for pancreatitis, a cholecystectomy, an appendectomy, a hysterectomy, ileojejunal bypass surgery, and bladder and rectum repair.
Physical examination revealed numerous erythematous tender 5-mm to 1-cm edematous papules, some with pustular centers. Lesions were scattered on the lower part of the legs to just above the knees (Figure 1), on the extensor aspect of the arms, on the upper part of the back, and around the neck. Joint swelling was not evident.
Serologic tests were negative for antinuclear antibody and rheumatoid factor. A complete blood cell count and chemistry profile revealed no abnormalities. A specimen from a previous biopsy had showed spongiotic and perivascular dermatitis. The results of direct immunoflorescence were negative. A second biopsy was performed (Figure 2 and Figure 3).
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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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