LAUSR

Kawasaki disease (KD) is an acute systemic inflammatory illness causing vasculitis. A diffuse polymorphous rash is one of the predominant features of patients presenting with KD. This rash can have a morbilliform, urticarial, micropustular, or further unspecific morphology. Psoriasis-like eruptions following KD were first described by Han et al. 2000 (Han M H et al., Br J Dermatol 2000; 142: 548–550), thereafter several case reports – describing over 30 children worldwide – have been published. It usually consists of a single episode with enduring remission, contrasting typical psoriasis. Furthermore, the eruptions can have an atypical presentation with less involvement of the anogenital area and more serous crusting (Haddock E S et al., J Am Acad Dermatol 2016; 75: 69–76), (Eberhard B A et al., J Pediatr 2000; 137, 4: 578–580). It is a well-known entity amongst dermatologists. However, acknowledgement by the paediatric community is limited. This is also mia (Hb 68 g/l) and an erythrocyte sedimentation rate (ESR) of 77 mm/1 h with normal platelets and no lymphopaenia. A nasopharyngeal aspirate PCR test was negative for respiratory viruses (including SARS-CoV-2). Serum SARS-CoV-2 IgG (anti-Nucleocapsid IgG and anti-Spike protein IgG) were negative. Echocardiography did not show any abnormalities. Fulfilling clinical criteria for complete KD, treatment with high-dose intravenous immunoglobulins (2 g/kg/dose) and high-dose oral acetyl salicylic acid (65 mg/kg/day) was initiated, and given his young age, intravenous methylprednisolone (2 mg/kg/day) was added. His clinical course was favourable and he defervesced within the first 24 hours after initiating KD treatment. On day 10 he was discharged on a weaning dose of oral prednisolone and low dose oral acetyl salicylic acid.