On your last day of pediatric preceptorship, you see a 13 year old boy complaining of "weird spots" on his lower abdomen and butt. He also says that since a few years ago, he often has burning pain in his hands and feet, especially when he has a fever. This pain radiates proximally and is sometimes relieved with rest. On exam, you notice the following two findings (the second is seen by the slit-lamp):
When you ask the patient about his family history, he tells you that his uncle on his mother's side recently received a kidney transplant. This uncle also has skin lesions and extremity pain.
Challenge: What is your diagnosis?
1. What is the skin finding?
2. What is the eye finding?
This case written by Kate Dinh.
Both images shown under fair use.