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This 13-year-old boy presented with a 2-month history of abdominal pain, bloody diarrhoea and weight loss (10 kg). On examination, he was wasted and had a non-tender, reticular, macular, pigmented rash on his anterior abdominal wall (fig 1). He attributed the rash to frequent use of a hot water bottle, which had helped to settle his pain. Inflammatory markers were raised, …
Competing interests: None declared.
Ethics approval: Patient and parental consent has been given for the publication of this photo.
Patient consent: Informed consent was obtained for publication of fig 1.