A rare cutaneous manifestation of Kawasaki disease

Kawasaki disease (KD) is the second common vasculitis in childhood following Henoch–Schonlein purpura. The common skin manifestations in KD are polymorphic exanthema, epidermal desquamation, erythema of the palms and soles and edema over the extremities. Skin erythema at the Bacille–Calmette–Guerin (BCG) vaccination site has been reported frequently in patients with KD. Skin ulceration after BCG vaccination in a context of KD was also reported but not as a part of the disease manifestation. We report a 14-month-old child who presented with clinical criteria for KD and developed left forearm ulcer that did not respond to antimicrobial therapy but responded well to immunomodulatory therapy.