Letters to Dermatology

Routine laboratory examinations showed an increased white blood cell count of 17,600/mm 3 (neutrophils: 74%, lymphocytes: 16%, monocytes: 8%, eosinophils: 2%, basophils: 1%) and elevated C-reactive protein of 5.9 mg/dl (normal range, 0–0.39). Liver and renal function tests were normal. Serum IgE was increased (830 IU; normal range, 0–400). A speckled pattern of antinuclear antibody was detected at 1: 2,560 (normal range ! 1: 40) without antibodies to ssDNA, dsDNA, Sm, SS-A/Ro or SS-B/La. The plasma zinc levels were normal. There were no symptoms suggestive of collagen diseases. Bacterial cultures from the pustules isolated only a small number of colonies of Staphylococcus epidermidis on several occasions, indicating a secondary colonization.