Blistering Distal Dactylitis

      A 60-year-old man with an unremarkable medical history presented with a 2-week history of left buttock pain and a 2-day history of 38°C fever. Physical examination revealed tenderness in the left buttock and painless edematous erythema in the second toe of the right foot. Enhanced computed tomography revealed a left piriformis abscess. The next day, a blister in the toe, extending over the digit except for the tip, was noted (Figure A and B). Blood culture revealed Staphylococcus aureus, detected in both the abscess and blister. He was diagnosed with piriformis pyomyositis, complicated with blistering distal dactylitis caused by S. aureus. His condition improved with antibacterial therapy and drainage. No recurrence was noted.
      FigureTense bullae extending over the right second toe, except for the tip. (A) dorsal site; (B) plantar site.
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