PMC10359707_01
Extensive skin ulcers in his abdomen (a) and back (b); mitten deformity of his feet (c) and hands (d); infected skin lesions (e).
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F1
He appeared pale and had widespread blisters, erosions, and mitten deformities on his hands and feet, with no edema present (Fig. 1a-e). He was severely malnourished (body weight 18 kg, <50th percentile) and exhibited a short stature (body height 110 cm, <5th percentile). Due to infected skin ulcers in the biopsy area, a kidney biopsy was not performed (Fig. 1a, b).
Clinical course of the case (A, completed prednisone full dose; B, after 3rd dose of CPA; C, completed 7th dose of CPA; D, at 12-month follow-up).
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F2
The patient then stopped taking prednisone and continued lisinopril for maintenance (Fig. 2 and Table 2). Although microscopic hematuria persisted, his proteinuria went into remission, and kidney function remained normal until the final follow-up, 18 months after discontinuing CPA treatment (Fig. 2; Table 2).