Malignant Masses or Mysterious Mimic?

A 60 year-old healthy woman gradually developed scattered non-healing painless abdominal blisters, diffuse abdominal pain, fatigue, and weight loss. Computed tomography (CT) showed right abdominopelvic soft tissue thickening up to 4.5 cm and hepatic and splenic masses. Liver biopsy showed acute and chronic inflammation. Stains for carcinoma, hematologic malignancy, fungi, and mycobacteria were negative. The blisters improved but did not resolve with amoxicillin/clavulanate.