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A 13-year-old boy presented with fever, severe papulopustular acne (figure 1) and arthralgia in the lower limbs, predominantly affecting the pelvis and knees. Blood tests showed elevated C reactive protein (31.9 mg/dL) and erythrocyte sedimentation rate (120 mm/hour) and neutrophilic leucocytosis (white cell count 16.8x10*9/L with 12.8×10*9/L neutrophils). Intravenous ceftriaxone and oral prednisolone were started with improvement of the patient’s general …
Contributors SA, GS and MR drafted the manuscript and collected the images. EG and RD critically reviewed the manuscript and gave final approval.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.
Patient consent for publication Obtained.