A 3.5-year-old girl presented with skin lesions and scarring over the chest and leg for a period of 1 year. She was apparently well a year back when she developed a pustule over the back and upper part of the chest that ruptured spontaneously forming an ulcer, which was extremely painful. She was treated by a local practitioner in her village, with local applications (details of treatment not available) without any response. Ulcer gradually increased in size and in due course healed with scarring. She had developed more such lesions in various parts of her body. The patient was then admitted to a hospital for 4 months as a case of non-healing ulcer, and a split skin graft was planned for her but could not be done for some reasons.
There was a history of appearance of new lesions on trivial trauma. There was no history of drug intake prior to the onset of her illness. Family histories were unremarkable.
Examination revealed an anaemic child with all anthropometric data below the third percentile. All vital parameters were within normal limits.
There were large scars present over the chest (), back, abdominal wall and thighs. She had ulcers over the left elbow (). The ulcers were large with irregular borders and rolled up edges. The base of the ulcer was covered with necrotic material. During her stay with us, she developed a small pustule over the dorsum of the right foot (). There were no joint swellings.
Healing with cribriform scarring.
Skin lesion beginning as a pustule.
Systemic examination was unremarkable.