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Images in paediatrics
From skin to bone: a boy with an unusual cause of acne
  1. Stefano Amoroso1,
  2. Giulia Spagnut2,
  3. Margherita Robazza2,
  4. Erika Giulioni3,
  5. Roberto Dall’Amico2
  1. 1 University of Trieste, Trieste, Italy
  2. 2 Department of Pediatrics, Azienda per l’Assistenza Sanitaria n 5 Friuli Occidentale, Pordenone, Italy
  3. 3 Department of Dermatology, Azienda per l’Assistenza Sanitaria n 5 Friuli Occidentale, Pordenone, Italy
  1. Correspondence to Dr Stefano Amoroso, University of Trieste, Trieste 34127, Italy; stefanoamoroso1234{at}

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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 …

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  • 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.