A 36-year-old Caucasian man sought care at our facility for rapidly progressive painful ulcers that were affecting his throat, tongue, genital area, and other parts of his body. He said that the lesions erupted 6 days earlier, and indicated that he had a history of recurrent oral aphthous ulcers.
Physical examination revealed 2 large inflammatory necrotic ulcers on his palate and right tonsil, with multiple small ulcers on the border of his tongue (FIGURE 1). Skin examination revealed scattered crateriform ulcerated plaques—particularly over his forearms, back, and scalp (FIGURE 2). Genital examination revealed a large necrotic ulcer underneath his glans penis, with several satellite perigenital ulcers in the groin. Examination of the antecubital fossa revealed pathergy from a blood test and intravenous cannula (FIGURE 3). There was no ocular involvement.
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