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Requests for reprints should be addressed to Tomoyuki Mutoh, MD, PhD, Department of Rheumatology, Osaki Citizen Hospital, 3-8-1 Furukawa Honami, Osaki, Miyagi 989-6183, Japan.
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.
Conflicts of Interest: The authors declare that they have no conflicts of interest.
Authorship: MT drafted the manuscript. TM edited the manuscript and had full access to all of the data. All authors were involved in clinical management and approved the final manuscript.
