{
  "abstract": "A 14-month-old boy with refractory epilepsy due to holoprosencephaly was receiving levetiracetam, phenobarbital, topiramate, clobazam and potassium bromide. Two months after bromide initiation, bilateral cheek erythema appeared and evolved over several months into exudative vegetating plaques ( figure 1A). Similar plaques developed on the anterior chest and distal extremities. Atypical infections and inflammatory dermatoses were considered. Bacterial, mycobacterial and fungal cultures were negative. Laboratory testing showed pseudohyperchloremia (153 mEq/L) with a negative anion gap (−31 mEq/L). The medication history, skin findings and laboratory profile supported a clinical diagnosis of bromoderma, and biopsy was deferred. Perampanel was introduced to facilitate bromide withdrawal. After bromide cessation, the plaques flattened over several months, leaving residual erythema (figure 1B), confirming the diagnosis. Seizures did not recur after transition to perampanel.",
  "authors": [
    {
      "affiliations": [
        "Department of Pediatrics and Neonatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan",
        "Department of Emergency and General Internal Medicine, Rakuwakai Marutamachi Byoin, Kyoto, Japan"
      ],
      "name": "Manabu Ida"
    },
    {
      "affiliations": [
        "Department of Pediatrics and Neonatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan"
      ],
      "name": "Hidehito Kondo"
    }
  ],
  "title": "Facial bromoderma in an infant with refractory epilepsy",
  "uid": "ddeecdd9-1e67-5709-b42e-f32b477e487a"
}