Diffuse Papular Eruption With Swelling of Joints in a Preschooler

Abstract

REPORT OF A CASE A 4-year-old black boy presented with polyarthritis and dermatitis. The mother had noticed swelling of the patient's joints over the preceding 2 to 3 years, although the child never complained of joint pain. At age 9 months, a chronic, fine papular rash, which persisted, developed (Fig 1). On physical examination, the child was small for his age, with a diffuse papular rash and swollen, nontender joints with a boggy synovium involving the wrists, elbows, ankles, and knees bilaterally (Fig 2). Several shotty cervical lymph nodes, the edge of the liver at the right costal margin, and the tip of the spleen could be palpated. Pulmonary and cardiac examinations showed normal findings. Ophthalmologic examination revealed uveitis and cataract formation bilaterally. More significant involvement of the right eye was present. Hematologic and chemistry profiles showed normal findings. The erythrocyte sedimentation rate was 52 mm/h. Antinuclear antibody and