Diagnostic Dilemma: A Case of Necrotizing Neutrophilic Dermatosis Misdiagnosed as Necrotizing Fasciitis

We report the case of a 15-year-old female who presented with a necrotizing neutrophilic dermatosis (NND) following an unknown insect bite on her right leg.Initially misdiagnosed, she developed sepsis and required intermediate care for acute kidney injury and volume support.Through multidisciplinary collaboration between Pediatrics, Infectious Diseases, Dermatology, and Plastic Surgery teams, the diagnosis of NND was suspected and confirmed via skin biopsy.She was successfully treated with corticosteroids and wound care, avoiding surgical intervention typically required for necrotizing fasciitis (NF).This case highlights the importance of considering NND in the differential diagnosis of progressive inflammatory skin lesions and emphasizes the value of conservative management to prevent iatrogenic complications.