The American Society of Dermatopathology

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Interactive Case Study - August 2013

Pustular Dermatitis

Amanda F. Marsch, MD; Kelli Ann Hutchens, MD

Question 1:

This biopsy (Figures 1-4) was taken from the left dorsal hand of a 79-year-old hospitalized male with a past medical history of myelodysplastic syndrome now with high fevers and an abrupt onset of asymptomatic, generalized papulopustules involving the trunk and extremities two days after being started on ceftriaxone and azithromycin for suspected community-acquired pneumonia. 

Figure 1. H&E, 200X

Figure 2. GMS, 100X


Figure 3. GMS, 200X 

Figure 4. PAS, 200X

Which of the following is the best diagnosis?