An 8 year and 10 month old boy was

hospitalized with chief complain of indurated

erythema on the face, body, arms, back and
thighs without pain and itching since 1 month
prior to admission. Physical examination
showed some nodules on the left lateral nasal,
left maxillary, right and left lumbar, right and
left posterior antebrachii, right and left anterior
femurs region. Laboratory examination
revealed anemia, leukopenia, elevated liver
enzymes, CRP and ASTO. At first, patient
was diagnosed and treated with rheumatic
fever, but after 2 months treatment there was
no recovery of skin lesion. Skin