Clinical presentation

The patient was a 36-year-old man, who had a 4-year history of ulcerative colitis (UC), for which he had received mesalazine, oral prednisolone and infliximab, neither of which had any long-lasting therapeutic benefit. This patient was admitted to our hospital with skin lesions, abdominal pain and diarrhoea. Two types of skin lesions were evident. First, one well-demarcated superficial ulcer, covered by yellow secretions and surrounded by a purple halo, was seen over the patient’s left knee region (figure 1A). Second, on the patient’s face (figure 1B) and trunk (figure 1C), there was a polymorphic rash consisting of open comedones, papules and some deeply set cysts, in association with numerous hyperpigmented scars. He was treated with minocycline 100 mg/day for …