Author: Anju Menon, Jothsana Srinivasan / Editor: Yasmin Sultan / Reviewer: Abdullah Rana / Codes: / Published: 18/10/2022 / Reviewed: 05/06/2026
A 2-year-old girl presents in the Paediatric Emergency Department (ED) at 23:00 hrs. Mother reports the girl has long standing eczema for which she is on Citareben as regular emollient and topical steroids for flare ups. She is concerned that the rash has suddenly got worse, especially over her knees. She also reports that the child was in pain and is now refusing to weight bear on her left leg. Otherwise, the child is feeling well.
Her past medical history is insignificant. There is history of atopy in the family.
On examination, the child appears in pain, but is alert and afebrile.
Widespread dry scaly skin is noted throughout with active inflammatory areas over the flexures neck, elbows, back of legs and back. She has scattered, uniform punched out vesicles and ulcers in clusters on an erythematous base over the face, especially around the eye, knee and buttock region. Swelling around left knee is also noted.
