case_images: PMC4903138_01
case_images: Photograph of the patient's back demonstrating an erythematous skin eruption with patches of desquamation, plaques, and papules.
case_images: CRIID2016-4983504.001.jpg
case_images: PMC4903138_01_CRIID2016-4983504.001.jpg
case_images: fig1
case_images: The eruption was composed of annular, scalene papules and plaques, some of which were ulcerated (Figure 1).
case_images: Plain radiographs of right tibia/fibula (a) and left forearm (b) showing multifocal region of cortical irregularities scattered throughout the diaphysis.
case_images: CRIID2016-4983504.002.jpg
case_images: PMC4903138_01_CRIID2016-4983504.002.jpg
case_images: fig2
case_images: Roentgenogram of the legs and forearms demonstrated cortical irregularities of the ulnar and radial diaphyses and of the tibial and fibular diaphyses, bilaterally (Figure 2).
case_images: Nuclear medicine bone scan of the whole body showing extensive bilateral polyostotic patchy uptake within the distal appendicular skeleton, including the forearms, hands, tibias/fibulas, and feet. ((a) and (b)) Feet and tibiae, respectively. (c) Bilateral forearms and hands. ((d) and (e)) Whole body scans.
case_images: CRIID2016-4983504.003.jpg
case_images: PMC4903138_01_CRIID2016-4983504.003.jpg
case_images: fig3
case_images: Follow-up bone scintigraphy was impressive for bilateral, extensive polyostotic uptake within the hands, feet, forearms, and tibiae/fibulae (Figures 3(a)-3(e)).
case_images: Photograph of the patient's back upon completion of treatment with doxycycline. Note dramatic improvement in lesions with few persistent areas of discoloration.
case_images: CRIID2016-4983504.004.jpg
case_images: PMC4903138_01_CRIID2016-4983504.004.jpg
case_images: fig4
case_images: At this time, the skin eruption was completely resolved (Figure 4).