We report the case of a 16-year-old male patient, with no morbid history, with a 1-month history of polymorphic, papular, erythematous lesions, slightly scaly extremities.
Subsequently, the lesions increased in quantity, flowing and developing crusts on their surface.
The cervical, axillary and inguinal folds showed multiple erosions.
She had a history of repeated consultations in primary care without a clear diagnosis, receiving steroidal therapy with no response and 3 days prior to hospitalization presented fever peaks with compromise of the general state.
He was admitted to the Hospital Clínico San Borja Arriarán hemodynamically stable with fever of 38.1oC.
Among his tests he highlighted negativity for human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), and VDRL.
The patient had a white blood cell count of 12,000/mm3, an erythrocyte sedimentation rate (ESR) of 68 mm/h and a C-reactive protein (CRP) of 50 mg/L.
The histopathological aspect of the 3 biopsies showed hyperkeratosis and acanthosis with fibrin-leukocyte scaffolds, ulceration with numerous necrotic keratinocytes and interphase lymphocytic infiltration band.
These findings confirmed the diagnostic suspicion.
Treatment with oral prednisone 60 mg/day was started and maintained for 1 month after which the dose was progressively decreased.
Since during this decrease she presented reactivations, 100 mg of oral steroids were added every 12 hours and the decrease of oral steroids was continued until the complete suspension of prednisone in a period of approximately 2 months.
The patient was maintained on oral medication for 5 weeks, followed by oral administration of 100 mg/day for 3 months.
Currently, the patient remains untreated and remains free of sprouts.
