PMC4211475_01
Patient #1: atypical target lesions and erosions.
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F1
We report a 7-year-old boy with a rapidly progressive macular-papular exanthema evolving to atypical target lesions involving less than 10% of the body surface, oral mucosa erosions, conjunctivitis and fever (38 C) in less than 24 hours (Patient #1 - Figure 1).
Patient #1: H&E (x40) - interface spongiosis, individual necrotic keratinocytes and perivascular inflammatory cell infiltrate.
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F2
Skin biopsy specimen taken from the border of a lesion on the back, showed dermo-epidermal detachment, apoptotic keratinocytes and inflammatory cell infiltrate, compatible with SJS (Figure 2).
PMC4211475_02
Patient #2: confluent maculopapular exanthema evolving to target lesions.
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F3
Patient #2, a 3-year old girl (Figure 3) developed a confluent maculopapular exanthema evolving to target lesions, localized to the face, chest and limbs, associated with fever and conjunctival hyperemia.
PMC4211475_03
Patient #3: atypical target lesions.
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F4
Patient #3, a 29-year old man (Figure 4), presented with a maculopapular exanthema and target lesions, localized to the face, trunk and limbs, fever and conjunctival hyperemia.
PMC4211475_04