Friday, October 30, 2009

What do you think?

This child was brought with a history of skin lesions which became pustular and gave rise to these ulcers with punched out edges. The child was in sepsis and passed away the next day. I am clueless as to what this could have been. Differentials on first impression by various doctors included varicella with secondary infection, and ulcers related to some kind of vasculitis among others. Please leave your comments as to what you think this could be. Thanks.


  1. pyoderma gangrenosum?

  2. I had an identical looking case to this in Uganda where the child of similar age presented with punched out lesions at different stages: some with a dry scabby plug (like the one in the midclavicular line of photo) and others with a sloughy crater. The lesions seemed to punch through the skill all over the body including the skull and joints. Significantly the mother also had some lesions on her skin but were much less severe. The child also died on the day following admission. The child tested negative for HIV. We were equally at a loss as to the underlying cause.


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