James, seven, is brought in by his parents for review of a rash that has developed over the past 24 hours.

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<p>James, seven, is brought in by his parents for review of a rash that has developed over the past 24 hours.</p><p>James has been unwell for a week, with intermittent fever, sore throat and abdominal pain. His parents thought he may have had the flu, which had been going around school, but he returned a negative COVID-19/influenza rapid antigen test.</p><p>While the fever has improved, James’ parents are concerned about the rash.</p><p>He has also developed bilateral hip and knee pain, and the abdominal pain has not resolved. The rash is non-tender and affects the lower limbs, buttocks and elbows.</p><p>Vital signs are within normal range — apart from blood pressure, which is slightly elevated at 125/85mmHg. Urinalysis is positive for blood.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.