title: A challenged case of Vogt-Koyanagi-Harada syndrome: when dermatological manifestations came first.
abstract: BACKGROUND
  Vogt-Koyanagi-Harada syndrome (VKHS) is an inflammatory systemic autoimmune disease principally affecting pigmented tissues in the ocular, auditory, integumentary and central nervous systems. Patients are generally women in the fourth decade of life. The prognosis is correlated mainly with the time between diagnosis and the start of treatment and number of recurrent episodes of inflammation. Most complications are mainly ocular. The purpose of this paper is to describe a clinical case of VKHS.
  
  
  METHODS
  A child with a challenging clinical presentation in which the dermatological symptoms occurred before ocular manifestations.
  
  
  CONCLUSIONS
  VKHS is rare in children and can be a diagnostic challenge. It seemed interesting to share this case as an opportunity to expand our knowledge of the clinical spectrum of diseases and reflect about current diagnostic criteria.
authors.affiliation: Hospital Prof Doutor Fernando Fonseca, IC19. 2700, Lisbon, Portugal. inescorga@gmail.com.
authors.forename: Inês
authors.initials: I
authors.lastname: Coutinho
authors.affiliation: Hospital Prof Doutor Fernando Fonseca, IC19. 2700, Lisbon, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Pedrosa
authors.affiliation: Hospital Prof Doutor Fernando Fonseca, IC19. 2700, Lisbon, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Santos
authors.affiliation: Hospital Beatriz Ângelo, Lisbon, Portugal.
authors.forename: Susana
authors.initials: S
authors.lastname: Pina
authors.affiliation: Hospital Prof Doutor Fernando Fonseca, IC19. 2700, Lisbon, Portugal.
authors.forename: Maria
authors.initials: M
authors.lastname: Lisboa
authors.affiliation: Hospital Prof Doutor Fernando Fonseca, IC19. 2700, Lisbon, Portugal.
authors.forename: Manuela
authors.initials: M
authors.lastname: Bernardo
authors.affiliation: Hospital Prof Doutor Fernando Fonseca, Lisbon, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Prieto
mesh_terms: D002648:Child; D006801:Humans; D008297:Male; D015864:Panuveitis / Q000209:etiology*; D012163:Retinal Detachment / Q000209:etiology*; D058471:Subretinal Fluid; D014607:Uveomeningoencephalitic Syndrome / Q000473:pathology*; D014786:Vision Disorders / Q000209:etiology*
keywords: Children; Clinical presentation; Diagnosis; Vogt–Koyanagi–Harada syndrome