case_images: PMC10585138_01
case_images: Clinical presentation of cutaneous eruption in Blau syndrome. (A) Initial presentation of diffuse scaly erythematous and skin-colored, fine papules located on the patient's back. (B) Two months after initial presentation, the patient had worsening cutaneous papules coalescing into plaques on the patient's back. (C) Follow-up visit approximately 1 year after initial presentation, showing significant improvement on methotrexate and hydroxychloroquine combination therapy for a total of 8 weeks.
case_images: fimmu-14-1279329-g001.jpg
case_images: PMC10585138_01_fimmu-14-1279329-g001.jpg
case_images: f1
case_images: A 13-month-old Hispanic boy presented with a sudden-onset papular eruption affecting the face, trunk, and extremities that progressively worsened over 2 months ( Figure 1A  initial presentation;  Figure 1B  shows cutaneous presentation at 2 months after initial presentation). In consultation with rheumatology, the patient was started on hydroxychloroquine 75 mg orally daily in combination with 7.5 mg methotrexate subcutaneously weekly in combination for 8 weeks, leading to complete resolution of dermatitis (assessed via visual inspection) ( Figure 1C ), pruritus (per parents' reports), arthritis (assessed via visual inspection and palpation by dermatology and rheumatology) and uveitis (assessed via visual inspection by dermatology and ophthalmology).
case_images: Representative image (200x) of a hematoxylin and eosin-stained section of skin from a punch biopsy from the right shoulder. Sections revealed numerous rounded aggregates of epithelioid histiocytes and multinucleated giant cells without a significant lymphocytic component ("naked" granulomas).
case_images: fimmu-14-1279329-g002.jpg
case_images: PMC10585138_01_fimmu-14-1279329-g002.jpg
case_images: f2
case_images: A 13-month-old Hispanic boy presented with a sudden-onset papular eruption affecting the face, trunk, and extremities that progressively worsened over 2 months ( Figure 1A  initial presentation;  Figure 1B  shows cutaneous presentation at 2 months after initial presentation). Biopsy of skin from the right shoulder was performed and revealed rounded aggregates of epithelioid histocytes and multinucleated giant cells without a significant lymphocytic component ("naked" granulomas) ( Figure 2 ).