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Unusual presentation of more common disease/injury
CASE REPORT
Recurrent blistering distal dactylitis due to Staphylococcus aureus in an immunocompetent elderly woman
  1. Colin A Hinkamp,
  2. Nikhil H Shah,
  3. Neal Holland,
  4. Ashleigh Wright
  1. Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA
  1. Correspondence to Colin A Hinkamp, chinkamp{at}ufl.edu

Summary

An 86-year-old woman presented with marked blistering of her left index fingertip and ulceration of the left middle fingertip, with a 2-year history of recurrent blistering and ulceration of her fingers bilaterally. She denied any preceding finger trauma, although she reported frequent gardening. She denied systemic symptoms. Her medical history was significant for a 2-year history of atrial fibrillation on carvedilol, amiodarone and apixaban, and she was a lifetime non-smoker. On admission, she had elevated inflammatory markers but unremarkable autoantibodies. Radiograph of the hand revealed diffuse soft tissue fullness and subtle irregularities at the tuft of the index finger, but all other investigations were unremarkable. The lesion was incised and drained, revealing blood-tinged purulent fluid. Wound biopsy revealed spongiosis with neutrophils, consistent with a diagnosis of blistering distal dactylitis.

  • dermatology
  • dermatological

https://doi.org/10.1136/bcr-2017-222772

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    Footnotes

    • Contributors CAH, first author, participated as the primary author of the case report draft, analysis and interpretation of data, final approval of the version published, and treatment of the patient. NHS participated by providing major revisions to the draft as necessary, analysis and interpretation of data, final approval of the version published and treatment of the patient. NH participated by providing revisions to the draft as necessary, analysis and interpretation of data and final approval of the version published. AW participated by providing revisions to the draft as necessary, analysis and interpretation of data, final approval of the version published and treatment of the patient.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.