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. 2023 Jan 1;13(1):e2023052. doi: 10.5826/dpc.1301a52

Figure 1.

Figure 1

Clinical aspect of Case 1 (A–E, 6-year-old child) and 2 (F–G, 13-year-old girl): redness and edema symmetrically involving the palmar (A,B,F) and plantar (C,D,E,G) surface of all the distal phalanges of the feet and hands, with the sole exception of the fifth toe; the palms of the hands and feet, in correspondence with the metacarpophalangeal and metatarsophalangeal joints, are also partially affected in case 1. Vesicle-bullous evolution is possible in areas subject to friction on rough pool surfaces (G). Clinical aspect of Case 3 (H–L, 13- and 15-year-old girls) and 4 (M–O, 3-year-old girl): Chilblain-like edematous and erythematous lesions involving the feet, on the dorsal surface (H-I-L), or both on the palmar-plantar and dorsal side (M-N-O). Note the presence of exulcerations on the third and fourth toes (H, L).