A 5-year-old white boy presented with a 15-day history of oral ulcers associated with pain and difficulty in eating. His medical history was significant for heart transplant 2 years previously, to treat idiopathic myocardiopathy. He had been on prednisone, tacrolimus and mycophenolate mofetil for the past 16 months to prevent transplant rejection.Physical examination revealed multiple shallow and deep ulcerations on the buccal mucosa and dorsum of the tongue (Fig. 1a,b), the largest 30 mm in diameter, covered with grey pseudomembranes and surrounded by an erythematous halo. There were no palpable
Syndrome in question
CASE REPORTA 32-year-old female patient has presented skin lesions for five months. Upon examination, there were well-delimited achromic patches, which were symmetrically located in the temporal and eyebrow regions, dorsum of hands and shoulders. She had poliosis circumscribed to eyelashes, eyebrows and scalp (Figures 1 e 2).One month before the onset of skin lesions, she presented one episode of intense headache and fever, followed by dysacusia, conjunctival hyperemia and bilateral amaurosis. Therefore, she had to be admitted to hospital and bilateral uveitis was the confirmed diagnosis ( Figure 3). CSF analysis revealed meningitis with mononuclear (lymphocytic) infiltration and brain CT scan showed diffuse cerebral edema. At hospital she was given high doses of systemic steroids and recovered from neurological and ophthalmologic conditions after 20 days.
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