CASE 1

A 7 – year - old Caucasian girl presented with a 3-month history of nodules on her thighs and buttocks. During a one-month period, the lesions gradually increased in size and number. They became indurate and tender. Similar nodules appeared on forearms after 4 months. The lesions gradually healed with a depressed scar. On physical examination, we found many indurate areas 10-40 mm in diameter .The surface of some of them was erythematous and scaly. The lesions were not ulcerated and did not have a discharge (figure 1). On examination, she was afebrile and healthy, organs such as heart, lungs, abdomen , joints and muscles were normal. Laboratory evaluation findings including complete blood cell count, liver and renal function test values, ESR, CRP,VDRL, BUN, Creatinin, complement were all normal .The titers for FANA, Anti ds DNA, Anti Sm, Anti Scl-70, Anti –RNP, Anti-Ro, Anti-La, Anti –Jo1, Anti Phospholipid Ab, Anti cardiolipin Ab, c- ANCA , p- ANCA were negative. A skin biopsy was taken (figures 2).