A case of guttate psoriasis with Kawasaki disease

A 2-year-old girl presented to our hospital with a high fever (39°C), an atypical rash, and cervical lymphadenopathy. She also had congestion and redness of the lips and was diagnosed as having Kawasaki disease. She was treated with aspirin (30 mg/kg/day) and γ-globulin (2 g/kg/day). Five days later, her fever resolved. When she visited us, hyperkeratotic papules were observed on her extremities, particularly around the knees. A skin biopsy specimen showed elongated rete ridges, vascular dilation, and edema in the papillary dermis. We diagnosed her skin eruption as guttate psoriasis. She was treated with mild topical steroids, and her skin condition was improved 2 months after the first visit. It has been suggested that super antigen is involved in the pathogenesis of guttate psoriasis, as well as Kawasaki disease. It is interesting that these diseases were both observed in this case.