Erythema marginatum: an uncommon presentation of acute rheumatic fever in a Nigerian adolescent girl—a case report

Abstract Background Erythema marginatum is an uncommon presentation in children with acute rheumatic fever and it one of the major criteria needed to make a diagnosis. It seen less than 10% cases. also reported be difficult detect black-skinned children. This first only patient present above since inception unit about 14 years ago Nigeria as far authors are aware, after careful literature search; hence, we report this case based on rarity symptom fever. Case O.E, 12-year-old Nigerian girl who presented features fever, these included rare manifestation erythema marginatum. She generalized skin eruptions trunk extremities, sparing face, migratory polyarthritis, congestive heart failure high grade continuous The lesions consisted papules, patches, plaques polycycles reticular pattern having serpiginous raised borders. Diagnostic investigations revealed elevated erythrocyte sedimentation rate 83mm/h, anti-streptolysin O titer 2020IU/L echocardiography which showed thickened mitral valves II regurgitation mild pulmonary artery hypertension. was treated anti-inflammatory anti-failure drugs commenced secondary prophylaxis benzathine penicillin. Skin resolved within 3 weeks management currently follow up. Conclusions We increase awareness possibility presenting our region, encourage early diagnosis reduce morbidity mortality from its sequel, disease.