Intended for healthcare professionals

Endgames Spot Diagnosis

Maculopapular eruptions and vesicles on the limbs and buttocks

BMJ 2020; 371 doi: (Published 02 December 2020) Cite this as: BMJ 2020;371:m4349
  1. Wu Guo, consultant dermatologist,
  2. Ge Qian, consultant dermatologist
  1. Department of Dermatology, Children’s Hospital affiliated to Zhengzhou University, 450053 Zhengzhou, China
  1. Correspondence to: W Guo guoscho{at}

A 3 year old girl presented to the dermatology department with three days of a progressively worsening rash and swelling of the extremities, and two days of a persisting fever of around 38.1°C. Initially her hands were swollen and itchy, then dome-shaped maculopapular eruptions developed and rapidly progressed to involve both elbows (fig 1). She also had multiple erythematous papules on the lower limbs and buttocks, and vesicles were present across the buttocks and ankles (fig 2). A few vesicles with crusting were also seen on her upper and lower lips.

Fig 1

Multiple dome-shaped maculopapular eruptions on hands

Fig 2

Scattered vesicles on the buttocks

She had a mild non-productive cough, malaise, and an …

View Full Text

Log in

Log in through your institution


* For online subscription