Palmar Erythema Research Articles

Spontaneous subconjunctival and retinal hemorrhage in acute on chronic liver failure: A case report and brief review of the literature

A 48-year-old male with a history of significant alcohol consumption (120 gm per day for six years) and a recent binge presented with jaundice for one month followed by abdominal distention for ten days. At presentation, he was normotensive (BP 110/70 mmHg), had tachycardia (HR 122/min), and maintained saturation at room air (Sp02 98%). Physical examination was remarkable for scleral icterus, palmar erythema, enlarged liver (span 14 cm), and free fluid in the abdomen. Laboratory investigations revealed anemia (Hemoglobin 10.1 gm%), leucocytosis (White blood cell count 17000/mm3), thrombocytopenia (Platelet count 90 X 103)/mm3), deranged liver function tests (Total bilirubin 9.5 gm/dl, Alanine Transaminase 52 U/L, Aspartate Transaminase (112 U/L), and coagulopathy (International normalized ratio 2.2, Prothrombin time 20 sec). A provisional diagnosis of Acute on Chronic Live Failure (ACLF) with severe alcoholic hepatitis as the precipitating event was made. The patient was started on standard therapy with nutritional supplementation, diuretics, laxatives. On day 4 of admission, the patient developed bilateral red-eye. There was no history of any diminution of vision, double diplopia, ocular discharge, orbital pain, antecedent trauma, cough, or any interventional procedure. Vision, pupillary reflexes, intraocular pressure as well as range of extraocular movements were normal.

Unusual Presentation of Pustular Eruption in Kawasaki Disease Shock Syndrome: A Case Report

The present study case report described a 46-month-old girl with Kawasaki disease shock syndrome (KDSS) who presented with five days of fevers, unilateral cervical lymphadenitis, pustular eruption, maculopapular rashes, erythema of palms and soles, conjunctivitis, cracked lips, and shock. Laboratory results showed elevated ESR & CRP, leukocytosis, normocytic anemia, and transaminitis. Pustular eruption Gram and Wright stains demonstrated numerous neutrophils. Echocardiogram showed normal results. Fluid resuscitation, broad spectrum antibiotics, inotropic drug, IVIG, and high dose aspirin were given. Diagnosis of Kawasaki disease was supported by clinical and laboratory features at the acute phase, in conjunction with periungual peeling of fingers and toes and thrombocytosis at the subacute phase. The patient made a complete recovery.The present study case showed an unusual pustular eruption in KDSS. Clinicians should consider these presentations to the diagnosis of KDSS and timely prescribed IVIG, to prevent coronary artery aneurysm. Keywords: Pustular eruption; Kawasaki disease shock syndrome

The effects of alcohol and illicit drug use on the skin

Early identification of cutaneous manifestations of alcohol and illicit drug use can aid in the diagnosis and management of these uses, as well as their sequelae. In addition, the effects of alcohol and illicit drug use on the skin can result in significant morbidity. Alcohol misuse can present with jaundice, pruritus, pigmentary alterations, urticaria, hair and nail changes, and oral changes. It is also a risk factor for skin cancer and infections. Vascular disturbances associated with alcohol misuse include telangiectasias, palmar erythema, caput medusae, and flushing. Diseases related to alcohol misuse include nutritional deficiencies, porphyria cutanea tarda, psoriasis, seborrheic dermatitis, nummular dermatitis, and rosacea. Other conditions seen in alcohol misuse include Dupuytren contracture, Peyronie disease, and pancreatitis. Dermatologists should also be aware of hepatotoxic medications that are commonly prescribed for skin diseases so as to avoid initiating hepatoxicity in patients who use alcohol. Illicit drug use can manifest with cutaneous fibrosis, scarring, granulomas, ulceration, pruritus, infections, cocaine-levamisole-induced vasculitis, tooth decay, and oral disease. By recognizing the cutaneous stigmata of alcohol and illicit drug use, dermatologists can aid in the identification and treatment of patients suffering from these addictions.

Drug desensitization in the coronavirus disease 2019 pandemic era: Local success to widespread potential

Drug desensitization in the coronavirus disease 2019 pandemic era: Local success to widespread potential

Palmar erythema and palmar papules as predictors for dermatomyositis-related acute/subacute interstitial lung disease: a retrospective study.

DM-related acute/subacute interstitial lung disease (A/S-ILD) remains a big therapeutic challenge due to its insidious onset and rapid development. In the present study, we aimed to investigate the association between clinical features of DM and ILD. We retrospectively assessed skin manifestations, muscle damage, laboratory tests, concurrent ILD and malignancy in 207 patients with DM and analysed the high-risk factors for ILD. In the 207 DM patients, 153 patients had ILD, in which 131 had chronic ILD (CILD) and 22 had A/S-ILD. The proportions of mechanic's hands, palmar papules and muscle weakness, as well as anti-melanoma differentiation-associated gene 5 (MDA5) antibody and lactic dehydrogenase (LDH), alanine aminotransferase (ALT) and ferritin in the ILD group were significantly higher compared with the non-ILD group. The onset age over 56 years, mechanic's hands and muscle weakness were independent predictive factors for ILD. The proportions of palmar papules, palmar erythema, anti-MDA5 antibody, ALT, aspartate aminotransferase (AST), LDH and ESR in the A/S-ILD group were higher compared with the CILD group. Palmar erythema and palmar papules were independent predictive factors for A/S-ILD. Palmar papules were positively correlated with anti-MDA5 antibody. The onset age over 56 years, mechanic's hands or muscle weakness predicted the incidence of DM-related ILD, while palmar erythema or palmar papules could predict potential DM-related A/S-ILD.

Childhood\u2010onset systemic lupus erythematosus with trisomy X and the increased risk for bone complications: a case report

BackgroundSystemic lupus erythematosus is a multi-organ inflammatory autoimmune disease; immune complexes are part of the pathogenesis, but not entirely responsible. Trisomy X is the most common female chromosomal abnormality and the role of an additional X chromosome in the development of systemic lupus erythematosus is well recognized. However, the potential complications and optimal management of childhood lupus with trisomy X remain unclear. Herein, we describe a case of childhood-onset systemic lupus erythematosus associated with severe bone complications presumably secondary to trisomy X.Case presentationA 16-year-old Japanese girl was diagnosed with childhood-onset systemic lupus erythematosus and trisomy X. A chromosomal abnormality (47, XXX) was incidentally identified on bone marrow examination initially done to determine the cause of pancytopenia. She had a persistent headache, fever for six days, diffuse hair loss, mucosal ulcers, butterfly eruptions, and palmar erythema. Furthermore, thrombocytopenia, anemia, and erythrocyte fragmentation were detected, suggesting secondary thrombotic microangiopathy. She was initially treated with intravenous methylprednisolone pulse therapy and prescribed monthly cyclophosphamide for severe disease activity, prednisolone, mycophenolate mofetil, and hydroxychloroquine as remission maintenance drugs. She developed generalized extremity pain that had been worsening throughout the disease. Extremity magnetic resonance imaging performed 12 months after the treatment onset revealed multifocal avascular necrosis, and dual-energy X-ray absorptiometry revealed further decreased bone mineral density. High plasma levels of factor VIII were detected by additional tests for coagulation functions, and we suspected the possibility that factor VIII might cause avascular necrosis due to thrombosis. Currently, she is being treated with prednisolone and MMF for SLE. However, her extremity pain has not been managed effectively even under the administration of non-steroidal anti-inflammatory drugs and pregabalin.ConclusionsAn additional X chromosome has been reported to be associated with factor VIII and osteoporosis. Additionally, elevated plasma levels of FVIII is the risk factors for thrombosis, which leads to the risk of avascular necrosis. Patients with systemic lupus erythematosus complicated by trisomy X might be at a higher risk of avascular necrosis and osteoporosis that can also manifest in childhood systemic lupus erythematosus.

Синдром Жубера як причина холестазу в дітей

Literature review and a case report of Joubert syndrome in a preschool child are presented. This syndrome is accompanied by chronic intrahepatic cholestasis, characteristic facial dysmorphia, congenital malformations of the urinary system, eyes pathology, confirmed by a molecular genetic test of TMEM67 gene mutations. Diagnostic aspects of this pathology have been reviewed. The clinical case description. Boy K was admitted to the pediatric hepatology department with respiratory and renal failure, decompensated acidosis. On admission, complaints included shortness of breath, severe itching, pale and dry skin, poor appetite and delayed physical development. On examination, dysembryogenic stigmas: large head circumference, elongated face, protruding forehead, high rounded eyebrows, deeply set eyes, hypertelorism, antimongoloid incision of the eyes, low auricles. The skin was pale, dry with the scratch marks on the arms and legs flexor surfaces. Ankles, wrists skin lichenification, bruising and hyperpigmentation was observed. Moderate palmar erythema, spider veins on the abdomen, watch-glass nails were present. The abdomen was enlarged due to hepatosplenomegaly. A clinical and paraclinical examination was conducted, the patient was consulted by related specialists. Based on the obtained data and molecular genetic examination, the diagnosis was made. Conclusion. Joubert's syndrome may have a clinical presentation similar to that in cholestatic liver disease with typical clinical and laboratory symptoms. The molecular genetic testing is an important workup component in children with liver pathology combined with damage to other organs and systems. Successful treatment is possible providing a multidisciplinary approach used. The study was conducted by the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the abovementioned institution. Informed consent of the child's parents was obtained for the research. The authors declare no conflict of interest. Keywords: Joubert syndrome, cholestasis, children.

Liver Cirrhosis: Modern Approach to the Problem

Liver Cirrhosis: Modern Approach to the Problem

Annals for Educators - 1 September 2020.

Annals for Educators - 1 September 2020.

Clinical features of anti-transcription intermediary factor 1γ (TIF1γ)-positive dermatomyositis with internal malignancy and investigation of the involvement of TIF1γ expression in tumors in the pathogenesis of cancer-associated dermatomyositis.

Anti-transcription intermediary factor 1γ (anti-TIF1γ) antibody (Ab) is significantly associated with internal malignancies in adult patients with dermatomyositis (DM). Although pathogenesis of cancer-associated DM is unknown, TIF1γ overexpression in tumors has been considered to be critical for the development of DM. The objective of this study was to investigate clinical characteristics of patients with anti-TIF1γ Ab-positive DM and elucidate risk factors that are potentially associated with internal malignancy. In addition, we compared the expression of TIF1γ in tumor tissues of patients with anti-TIF1γ Ab-positive DM, anti-TIF1γ Ab-negative DM and without DM in order to investigate the pathogenesis of cancer-associated DM. We analyzed 77 Japanese patients with DM, and found 19 patients to be positive for anti-TIF1γ Ab. Patients with anti-TIF1γ Ab-positive DM were older and presented heliotrope rash and flagellate erythema more frequently than patients without anti-TIF1γ Ab (P<0.05). Interstitial lung disease (ILD) and rapidly progressive ILD, as well as palmar violaceous erythema, were less frequent in patients with anti-TIF1γ Ab than in patients without. Furthermore, internal malignancy and dysphagia were significantly more frequent in the anti-TIF1γ Ab-positive group (P<0.01). Male sex and dysphagia were significantly associated with internal malignancy in patients with anti-TIF1γ Ab-positive DM (P<0.01 and <0.05, respectively). Using immunohistochemistry, we examined the TIF1γ expression in tumors of 11 patients with cancer-associated DM (anti-TIF1γ Ab-positive, nine; anti-TIF1γ Ab-negative, two) and 25 patients without DM. TIF1γ was highly expressed in all tumors, and there was no significant difference in TIF1γ expression between patients with and without DM. Furthermore, TIF1γ expressions in tumors were similar irrespective of the presence of anti-TIF1γ Ab. These results suggest that anti-TIF1γ antibody may not be simply induced by overexpression of TIF1γ in tumors in patients with DM, but that other mechanisms may exist.

Primary Biliary Cirrhosis

Primary biliary cirrhosis (PBC) is an inflammatory disease or chronic liver inflammation, with slow progressive characteristic and is an unknown cholestatic liver disease and commonly happen in middle-aged women. The incidence of PBC is 0.03 – 5.8 per 100,000 people per year, prevalence of 1.91-40.2 per 100,000 people and continues to increase. Based on the American Association for Study of Liver Disease criteria, the diagnosis of PBC is made in the presence of two out of three criteria, which are increase of alkaline phosphatase, positive antimitochondrial antibodies (AMA), and histopathology examination.We reported a case which is very rarely found; a 47-year-old women with the chief complaints of decrease consciousness and jaundice. In physical examination, there were anaemic conjunctiva, icteric sclera, hepatosplenomegaly, palmar erythema, and liver nails. In the patient, there was no evidence of obstruction in imaging with two-fold increase of alkaline phosphatase and positive AMA test. Patient was hospitalised to slow down the progression of the disease and to overcome the signs (e.g. pruritus, osteoporosis and sicca syndrome).

Palmar erythema: A diagnostic clue of juvenile dermatomyositis.

Journal of Paediatrics and Child HealthVolume 56, Issue 7 p. 1161-1161 Image of the Month Palmar erythema: A diagnostic clue of juvenile dermatomyositis First published: 28 July 2020 https://doi.org/10.1111/jpc.2_14739Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume56, Issue7July 2020Pages 1161-1161 RelatedInformation

Cutaneous Manifestation of Amraz- E- Kabid ( Liver Diseases) : A Review

According to various Unani physicians, the kabid (liver) is considered as one of the most vital organ of the body, responsible for the metabolic functions mostly the production of Akhlaat(humors). Amraze kabid (liver diseases) are frequently associated with abnormalities of the skin, nails and hair. Amraze kabid can give rise to numerous extrahepatic disorders among which skin disease occupies a central place Yaraqan Asfar (Jaundice), and pruritis, Fasad al-Lawn (pigmentary changes), Dakhis (paronychia), palmar erythema, all are recognized sequelae of amraze kabid. Knowledge of these cutaneous manifestations helps in suspecting an underlying systemic illness. Ali Ibne Abbas Majoosi, Ibn Sina, Ibn Rushd, and other Unani physicians have described various cutaneous parameters for the determination of the temperament of the liver. The present review study was aimed to focus on the cutaneous manifestations described by Greco Arabic physicians that may be found in various liver diseases.

Evaluation of the Sabadell noninvasive hepatitis C-related cirrhosis early detection index and right lobe diameter to albumin ratio in the prediction of presence of varices in Egyptian cirrhotic patients

IntroductionPortal hypertension in cirrhosis results from progressive fibrotic remodeling of the liver, which increases the resistance to hepatic sinusoidal blood flow. Increased portal venous pressure causes esophageal and gastric varices, which contribute substantially to cirrhosis-related morbidity and mortality. The gold standard in the diagnosis of varices is esophagogastroduodenoscopy, but identification of noninvasive predictors of esophageal varices (OVs) will allow upper gastrointestinal tract endoscopy to be carried out only in a selected group of patients. Different noninvasive parameters including clinical, laboratory, and sonographic predictors are an alternative approach to perform selective screening endoscopy only in patients at high risk.ObjectiveOur objective is to evaluate whether the noninvasive hepatitis C-related cirrhosis early detection (NIHCED) score and the right lobe diameter to albumin ratio can predict the presence of OVs in a group of Egyptian cirrhotic patients.Patients and methodsSeventy-five patients with liver cirrhosis were enrolled in the study depending on the clinical evidence of stigmata of chronic liver disease (e.g. jaundice, ascites, palmar erythema, spider naevi, etc.) and ultrasonographic features of liver cirrhosis (e.g. coarse echo texture, shrunken liver, etc.).ResultsAccording to the esophagogastroduodenoscopy results, the patients were categorized into two groups: those with OVs (47 patients, 63%) and those without OVs (28 patients, 37%).Receiver operating characteristic curve analysis of the NIHCED score was applied to both groups with a cutoff score of more than 45. The estimation cohort study had a sensitivity of 70%, specificity of 78%, and diagnostic accuracy of 74% with an area under the receiver operating characteristic curve of 0.77 (95% confidence interval, 0.66–0.86).Receiver operating characteristic curve analysis of the right lobe diameter to albumin ratio was applied to both groups with a cutoff score of more than 2.80. The estimation cohort study had a sensitivity of 80%, specificity of 53%, and diagnostic accuracy of 67% with an area under the receiver operating characteristic curve of 0.67 (95% confidence interval, 0.55–0.77).ConclusionThe NIHCED score and right lobe diameter to albumin ratio are simple noninvasive predictors of the presence of varices in Egyptian patients with liver cirrhosis.

Isolated palmar located postherpetic Erythema multiforme: unique pathognomonic clinical presentation!

Isolated palmar located postherpetic Erythema multiforme: unique pathognomonic clinical presentation!

2291 Drug-Induced Autoimmune Hepatitis Secondary to Infliximab

INTRODUCTION: The increased utilization of Infliximab therapy has produced a small number of reported cases associating Infliximab with varying patterns of drug-induced liver injury. We present a rare case report of drug-induced autoimmune hepatitis that embodies a realistic presentation of a potentially underreported liver injury pattern that can occur following the induction of Infliximab therapy. CASE DESCRIPTION/METHODS: A 36 yo female with a PMHx significant for Crohn’s Disease, HTN and chronic alcohol abuse was admitted for generalized body aches, right upper quadrant abdominal pain, and shortness of breath. The patient described a recent increase to her alcohol consumption from 48 to 120 oz of beer daily for the last two weeks. The patient otherwise denied: smoking tobacco, illicit drugs, and naturopathic or over the counter medications. Physical examination revealed jaundice and tenderness to the RUQ of the patient’s abdomen. No evidence of ascites, palmar erythema, spider angiomata or protein malnutrition were present. Lab Findings revealed: AST/ALT: 1135/175, T. Bili: 10.9, AP: 230, Albumin: 2.7, Platelets: 233, INR: 1.1. The patient’s lab findings and subjective history validated continued concern for alcoholic hepatitis. Viral hepatitis serologies and autoimmune markers were collected and produced negative results except for a positive Anti-Nuclear Ab; ANA Titer: 1:2560. A RUQ Ultrasound with Doppler revealed hepatomegaly without signs of cirrhosis. Histopathologic results from biopsy revealed florid lymphoplasmacytic portal inflammation, stage 2-3 with periportal/bridging fibrosis and was without steatosis or steatohepatitis; findings consistent with the diagnosis of autoimmune hepatitis and drug induced liver injury. DISCUSSION: A detailed review of the patient’s medications revealed Infliximab infusions were initiated 5 months prior ,with the most recent being 3 weeks before presentation. The patient had no new medication exposures. Despite an initial concern for alcoholic hepatitis, the patient’s biopsy results showed no evidence of an alcoholic liver injury pattern. The positive ANA, histopathology, favorable response to infliximab withdrawal followed by steroid induced immunosuppression was consistent with the diagnosis of drug-induced autoimmune hepatitis (DIAIH). This case suggests patients receiving Infliximab therapy with elevations in liver function tests require thorough evaluation and strong consideration of biopsy for appropriate diagnosis.

Nonalcoholic fatty liver disease and alcoholic liver disease: metabolic diseases with systemic manifestations.

The progression of liver disease is portrayed by several common, overarching signs and symptoms. Classically, these include findings such as spider angiomata, jaundice, palmar erythema, and as cirrhosis decompensates, ascites, variceal hemorrhage (VH), hepatic encephalopathy (HE), and hepatocellular carcinoma (HCC). Aside from these universal hallmarks among cirrhotics, patients with nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) harbor their own distinct systemic associations and manifestations. NAFLD is tightly linked to metabolic syndrome, which appears to be a driving force for a multitude of comorbidities, such as insulin resistance, cardiovascular disease, chronic kidney disease (CKD), obstructive sleep apnea (OSA), as well as increased malignancy risk. ALD also maintains a variety of comorbidities congruent with systemic effects of chronic alcohol use. These findings are highlighted by cardiovascular conditions, neuronal damage, myopathy, nutritional deficiencies, chronic pancreatitis, in addition to increased malignancy risk. While a general, guideline-driven management for all cirrhotic patients remains imperative for minimizing risk of complications, a tailored treatment strategy is useful for patients with NAFLD and ALD who entertain their own constellation of unique systemic manifestations.

Incidence of dengue fever and its clinical profile during an outbreak in a rural area in Tamil Nadu

Background: In Southeast Asian countries, dengue is the major cause of pediatric morbidity and mortality and in that India reports the maximum number of cases. The annual incidence of dengue in India ranges from 8 to 33 million cases per year and an increased risk of dengue virus infection in children older than 5 years of age have been documented. Aim: The main objective of this study was to assess the incidence of dengue among the fever cases and to assess the clinical profile of various types of dengue fever and also to assess the predictive variables for the severity of dengue and their clinical outcomes. Methodology: A prospective longitudinal study was conducted at a pediatric hospital in a rural area of Tamil Nadu for a period of 6 months. A total of 325 patients were included in the study based on the study period and the inclusion criteria. For all the cases that were having a fever, basic blood investigations which includes hemoglobin, total count, and platelet count were performed along with peripheral smear study for malaria, dengue card test, and liver function test. Further, dengue positive patients were grouped into non-severe and severe dengue fever based on the operational definition formulated by the WHO. Results: The overall incidence of dengue among all the patients with fever was 71.3% among which 83.6% were non-severe dengue and the remaining 13.6% of the patients had severe dengue. Clinical signs such as palmar erythema, splenomegaly, and bleeding manifestations were more common in severe dengue patients than that of non-severe dengue, and this difference was found to be statistically significant. Hemoglobin and platelet count was found to be much lower among the patients with severe dengue along with raised liver enzymes (serum glutamic-oxaloacetic transaminase and serum glutamic pyruvic transaminase) than that of the non-severe dengue, and the difference was found to be statistically significant. Majority of the patients with severe dengue received crystalloid and few patients received blood products whereas only very few with non-severe dengue received crystalloids, and none of the patients in this group received blood products. Conclusion: Health-care personnel of all levels must be made aware of the clinical signs and symptoms of all dengue types. Early recognition, precise assessment and appropriate treatment with the help of the WHO revised classification and management guidelines would reduce the mortality due to dengue fever.

Ethanol induces skin hyperpigmentation in mice with aldehyde dehydrogenase 2 deficiency

Alcohol induces various cutaneous changes, such as palmar erythema and jaundice. However, alcohol-induced skin hyperpigmentation due to melanin deposition has not been reported. Aldehyde dehydrogenase 2 (ALDH2), one of 19 human ALDH isozymes, metabolizes endogenous and exogenous aldehydes to their respective carboxylic acids. Reduced ALDH2 greatly affects acetaldehyde metabolism, leading to its accumulation in the body after the consumption of alcohol and the consequent development of a wide range of phenotypes. In the present study, we report a novel phenotype manifesting in a mouse model with the altered expression of ALDH2. Aldh2 knockout (Aldh2+/- and Aldh2-/-) and wild-type (Aldh2+/+) mice were fed a standard solid rodent chow and a bottle of ethanol solution at concentrations of 0%, 3%, 10%, or 20% (v/v) for more than 10 weeks. The intensity of their skin pigmentation was evaluated by macroscopic observation. Ethanol-exposed Aldh2+/- and Aldh2-/- mice exhibited dose-dependent skin pigmentation in areas of hairless skin, including the soles of the paws and tail; no such changes were observed in wild-type mice. The intensity of skin pigmentation correlated with the number of Aldh2 alleles that were altered in the mice (i.e., 0, 1 and 2 for Aldh2+/+, Aldh2+/-, Aldh2-/-, respectively). Interestingly, the skin pigmentation changes reversed upon the discontinuation of ethanol. The histological examination of the pigmented skin demonstrated the presence of melanin-like deposits, mainly in the epidermis. In conclusion, we report a novel finding that the intake of ethanol induces skin hyperpigmentation in an ALDH2 activity-dependent manner.

Dermatological findings in common rheumatologic diseases in children

The aim of this study is to outline the common dermatological findings in pediatric rheumatologic diseases. A total of 45 patients, nineteen with juvenile idiopathic arthritis (JIA), eight with Familial Mediterranean Fever (FMF), six with scleroderma (SSc), seven with systemic lupus erythematosus (SLE), and five with dermatomyositis (DM) were included. Control group for JIA consisted of randomly chosen 19 healthy subjects of the same age and gender. The age, sex, duration of disease, site and type of lesions on skin, nails and scalp and systemic drug use were recorded. χ2 test was used. The most common skin findings in patients with psoriatic JIA were flexural psoriatic lesions, the most common nail findings were periungual desquamation and distal onycholysis, while the most common scalp findings were erythema and scaling. The most common skin finding in patients with oligoarthritis was photosensitivity, while the most common nail finding was periungual erythema, and the most common scalp findings were erythema and scaling. We saw urticarial rash, dermatographism, nail pitting and telogen effluvium in one patient with systemic arthritis; and photosensitivity, livedo reticularis and periungual erythema in another patient with RF-negative polyarthritis. Vascular skin lesions like RaynaudÂ’s phenomenon, livedo reticularis, palmar erythema, periungual telangiectasia and nailfold abnormalities were common in SLE, DM and SSc. Patients with FMF displayed signs of atopy. Specific skin lesions can be the peculiar features of rheumatologic diseases in pediatric population. Since it is not always easy to perform biopsy in children to confirm skin involvement of a rheumatologic disease, skin findings can help both dermatologists and rheumatologists in diagnosis.