Forum for Nordic Dermato-Venereology Nr 3, 2018 | Page 30

Quiz A Growing Wound after Sural Nerve Biopsy: A Quiz G eorg A uthried , md , consultant dermatologist 1 and S umangali C handra P rasad , md 2 Landesklinikum Amstetten, Krankenhausstrasse 21, AT-3300 Amstetten, Austria, and Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark. E-mail: [email protected] 1 A 78-year-old man, currently under investigation for mono­ neuritis multiplex, was referred from the department of neu- rology due to 3 painful lesions on his lower limb. The wounds had a spontaneous onset 3 months before and worsened after using tight footwear. 2 Systemic treatment with prednisolone 75 mg/day and topical tacrolimus ointment 0.1% for the wound edges was started. Despite the existing wound, a biopsy of the left sural nerve was performed 5 days after and the wound area increased almost immediately (Fig. 2). Clinical examination showed an undermining violaceous wound border, lack of healing and severe tenderness at site of ulceration (Fig. 1). What is your diagnosis? See next page for answer. Fig. 1. Clinical aspect before sural nerve biopsy. Fig. 2. Wound area a few days after sural nerve biopsy. 92 Forum for Nord Derm Ven 2018, Vol. 23, No. 3