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The patient, a 47-year-old man, was treated in the emergency department for two days for 2 days with pustules on his hands.
week before his visit, he had begun treating pharyngitis with penicillin V potassium.
swab culture obtained group A beta-hemolytic streptococcus.
physical examination found multiple pustules on the palms of both hands and feet, surrounded by erythema.
joint examination found abnormalities.
laboratory test results showed that the absolute count of nephroblasts was 14,900 per cubic meter, and the C-reactive protein level was 30 mg/L;
biopsy marker for palm lesions punctures found sub-corneal pustules and mononucleosis in the der skin.
these findings are consistent with pustules after streptococcus infection, a rare complication of Streptococcus A infection that can be misdiagnosed as palm-footed psoriasis or acute systemic papules.
the patient began local treatment with chlorpyrene, and the rash disappeared after 14 days of treatment.
1 year of follow-up, the patient's rash did not relapse.
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