CASE PRESENTATION

A 33-month-old boy was referred for a 2-month history of a diffuse rash, unsuccessfully treated with oral dexamethasone and fluconazole. He was delivered at term with normal birthweight. His immunizations were up-to-date. According to his parents, he recently began to lose previously acquired motor and verbal skills. There was no family history of rheumatologic or hematologic diseases. On admission, the child was irritable, non-verbal, but had normal vital signs. Physical exam was remarkable for mild hepatomegaly and an inability to walk. Skin examination showed hair depigmentation (Figure 1); a sharply marginated erythematous dermatitis with irregular raised borders on the limbs, trunk, and perianal region (Figures 2 and 3), and pitting edema in both feet (Figure 3).

中文翻译：

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幼儿边缘明显的红斑性皮炎

案例展示

一名 33 个月大的男孩因 2 个月的弥漫性皮疹病史被转诊，口服地塞米松和氟康唑治疗失败。他足月分娩，出生体重正常。他的免疫接种是最新的。据他的父母说，他最近开始失去以前获得的运动和语言技能。无风湿病或血液病家族史。入院时，孩子易怒，不能说话，但生命体征正常。体格检查显示有轻度肝肿大和无法行走。皮肤检查显示毛发脱色（图 1）；一种边缘明显的红斑性皮炎，四肢、躯干和肛周区域边缘不规则凸起（图 2 和 3），双脚凹陷性水肿（图 3）。