PMC4763574_01
(a) Day 1, stellate sharply defined purpuric patches on the lower and upper limbs. (b) Day 7, necrotic areas of skin with underlying ulcers with red granulation tissue and healing with hypopigmentation
IDOJ-7-24-g001.jpg
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F1
The child progressed to develop multiple ulcers with red to pale granulation tissue covered with necrotic skin [Figure 1].
PMC4763574_02
Sloughing necrotic gangrenous skin with underlying ulcers with granulation tissue over the lower trunk, gluteal region, thighs, and legs
IDOJ-7-24-g003.jpg
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F2
On examination, black necrotic patches overlying ulcers were present over the gluteal region, lower limbs, trunk, and finger tips [Figure 2].
PMC4763574_03
(a) Day 1, erythematous to purplish well-defined confluent patches over the gluteal region, thighs, and legs. (b) Day 4, black infarcted areas of skin over the buttocks and lower limb. (c) Day 10, ulcers with slough and pale red granulation tissue with overlying gangrenous areas of skin on the gluteal region and thighs
IDOJ-7-24-g004.jpg
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F3
On cutaneous examination, sharply demarcated purpuric patches with necrotic changes were present over the upper limb, buttocks, and lower limb [Figure 3].
PMC4763574_04
(a) Stellate brownish patches present over the gluteal region, upper and lower limbs. (b) Well-defined black necrotic areas of skin over the thighs and legs
IDOJ-7-24-g005.jpg
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F4
History of joint pain was present [Figure 4].