Picture of the Month

摘要

A 3-YEAR-OLD BOY PRESENTED TO AN OUT-patient dermatology clinic for an outbreak of pustules involving his inguinal area. It then rapidly spread to his chest, abdomen, and extremities. His only other complaints were that he was feeling tired and had experienced some leg pain. He was otherwise afebrile and was eating and drinking normally. There was no family history of any similar medical conditions. On examination,he was a healthy-appearing boy with a widespread eruption characterized by erythematous, annular, and poly-cyclic plaques studded with numerous tiny pustules (Figure 1 and Figure 2). The pustules coalesced into larger collections of pus with later rupture yielding erosions and collarettes of scale. Laboratory screening indicated mild transaminitis with an aspartate aminotrans-ferase level of 68 U/L (to convert to microkatals per liter, multiply by 0.01667) and normal levels of alahine ami-notransferase, alkaline phosphatase, calcium, and albumin. He also had an elevated white blood cell count of 15 400 cells/mL with 57% segmented neutrophils. Blood culture results were negative.