Where did Edward VI’s skin ulcers come from?

On 12 May 1553, the imperial ambassador, Jean Scheyfve, wrote to HRE Charles V to update him on King Edward VI’s illness.

Scheyfve had only bad news to report, declaring that “it is held for certain that [Edward] cannot escape. The physicians are now all agreed that he is suffering from a suppurating tumour (apostème) on the lung, or that at least his lung is attacked. He is beginning to break out in ulcers; he is vexed by a harsh, continuous cough, his body is dry and burning, his belly is swollen, he has a slow fever upon him that never leaves him.”

I have argued that these symptoms are all indicators that the king had atypical cystic fibrosis. Although it is easy to see the connection between the pulmonary problems and CF, where do the ulcers on Edward’s skin fit in with this theory?

Atypical CF patients usually have chronic airway infections, and one of the most common culprits of these infections is the pathogen Pseudomonas aeruginosa. Nowadays, P. aeruginosa is treated with antibiotics and can be fought with reasonable success. However, in Edward’s time there was no such hope of keeping the P. aeruginosa from running amok. One of the things this nasty little bacteria can do is cause “hemorrhagic and necrotic lesions, with surrounding erythema; subcutaneous nodules, deep abscesses, cellulitis, and fasciitis; in burns, black or violaceous discoloration or eschar”. In short, it can give you what looks like little ulcers on your skin.

If Edward had non-classic CF then the long-standing infection of P. aeruginosa could have opportunistically spread to other systems in his body –  such as his skin — as his immune system weakened. Thus, he broke out in ulcers. This means the ulcers could be another piece of evidence indicating non-classic CF was a distinct possibility for the cause of Edward’s premature death.