From skin to bone: a boy with an unusual cause of acne

A 13-year-old boy presented with fever, severe papulopustular acne (figure 1) and arthralgia in the lower limbs, predominantly affecting the pelvis and knees. Blood tests showed elevated C reactive protein (31.9 mg/dL) and erythrocyte sedimentation rate (120 mm/hour) and neutrophilic leucocytosis (white cell count 16.8x10*9/L with 12.8×10*9/L neutrophils). Intravenous ceftriaxone and oral prednisolone were started with improvement of the patient’s general …