LAUSR

A 25-year-old woman with Crohn’s disease that was well controlled with infliximab presented with a 10-month history of violaceous plaques. Physical examination revealed multiple red to violaceous papules and plaques on the extensor surfaces of her elbows, knees, toes, fingers, and dorsal aspects of her feet (Fig 1). She denied fever, arthralgias, pain, or other systemic symptoms. The skin lesions had been unsuccessfully treated with oral prednisone, intralesional triamcinolone, topical clobetasol, and pimecrolimus. A shave biopsy of a nodule from the left elbow was obtained and sent for histopathologic evaluation (Figs 2 and 3). Tissue culture and special stains were negative for bacteria, acid-fast bacteria, and deep fungal organisms.