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VALENCIA-HERRERA A, GANOZA-GRANADOS L, CAMARGO-SÁNCHEZ K, CHIRINO-BARCELÓ YA, TOLEDO-BAHENA M. Asymmetrical Periflexural Exanthem Associated with SARS-CoV-2 Infection in a Paediatric Patient. Acta Derm Venereol 2023; 103:adv00839. [PMID: 36172694 PMCID: PMC9885288 DOI: 10.2340/actadv.v102.3499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/12/2022] [Indexed: 01/07/2023] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Adriana VALENCIA-HERRERA
- Dermatology Service, Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Delegación Cuauhtémoc, Colonia Doctores, CP 06720 Mexico City
| | - Luciana GANOZA-GRANADOS
- Dermatology Service, Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Delegación Cuauhtémoc, Colonia Doctores, CP 06720 Mexico City
| | - Karen CAMARGO-SÁNCHEZ
- Dermatology Service, Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Delegación Cuauhtémoc, Colonia Doctores, CP 06720 Mexico City
| | | | - Mirna TOLEDO-BAHENA
- Dermatology Service, Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Delegación Cuauhtémoc, Colonia Doctores, CP 06720 Mexico City,E-mail:
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2
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Yelich A, Dazé R, Moon S. An asymmetric morbilliform eruption in an adult male. JAAD Case Rep 2023; 31:142-145. [PMID: 36590078 PMCID: PMC9794460 DOI: 10.1016/j.jdcr.2022.11.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Allyson Yelich
- Dermatology Department, HCA Healthcare/USF Morsani College of Medicine GME: Largo Medical Center, Largo, Florida,Correspondence to: Allyson Yelich, DO, Dermatology Department, HCA Healthcare/USF Morsani College of Medicine GME: Largo Hospital, Largo, FL 33770
| | - Robert Dazé
- Dermatology Department, HCA Healthcare/USF Morsani College of Medicine GME: Largo Medical Center, Largo, Florida
| | - Summer Moon
- Dermatology Department, HCA Healthcare/USF Morsani College of Medicine GME: Largo Medical Center, Largo, Florida,Bay Dermatology & Cosmetic Surgery, Largo, Florida
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3
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Shakshouk H, Johnson EF, Peters MS, Wieland CN, Comfere NI, Lehman JS. Cutaneous eccrine inflammation and necrosis: review of inflammatory disorders affecting the eccrine apparatus including new associations. Hum Pathol 2021; 118:71-85. [PMID: 34450084 DOI: 10.1016/j.humpath.2021.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022]
Abstract
Despite being frequently overlooked during the examination of histopathological sections, eccrine sweat glands can offer clues for diagnosing various skin conditions. They provide important functions and can lead to several diseases when inflamed or injured. This review article provides information regarding eccrine physiology as well as well-established and novel entities that occur in association with eccrine gland pathology.
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Affiliation(s)
- Hadir Shakshouk
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Andrology and Venereology, Alexandria University, Alexandria, 21131, Egypt
| | - Emma F Johnson
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Margot S Peters
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Carilyn N Wieland
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Nneka I Comfere
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Julia S Lehman
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
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Unilateral Mediothoracic Exanthem: Case Reports of two Indian Female Children. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2019. [DOI: 10.2478/sjdv-2019-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Unilateral mediothoracic exanthem is a variant of a common entity in Western literature, namely Asymmetric Periflexural Exanthem of Childhood (APEC). Less than ten cases of unilateral mediothoracic exanthem have been described worldwide, and only two are reported in Indian literature. Herein, we report two childhood cases of uni-lateral mediothoracic exanthem from India. Dermatologists must be aware of this self-limiting condition, in order to avoid invasive and exhaustive investigations and misdiagnosis.
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Prćić S, Gajinov Z, Radulović A, Matić M, Matić A. Unilateral Laterothoracic Exanthem – Asymmetric Periflexural Exanthem of Childhood – a Case Report and Literature Review. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2018. [DOI: 10.1515/sjdv-2017-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Unilateral laterothoracic exanthem (ULE), or asymmetric periflexural exanthem of childhood (APEC), is an uncommon skin eruption that usually occurs in childhood, with unilateral distribution and self limiting course. The etiology of ULE is unknown, but viral cause is suspected. We report a case of ULE in a 4-year-old girl, that was associated with parvo virus B19 infection, and a brief selected literature review. The patient presented with unilateral maculopapular rash on the left side of the body which was asymptomatic and resolved spontaneously within 5 weeks. The clinical diagnosis of ULE may be precise, ruling out a broad spectrum of differential diagnosis, and prevent unnecessary examinations, whereas the patient is informed about the benign self-limiting nature of ULE.
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Affiliation(s)
- Sonja Prćić
- Institute for Child and Youth Health Care of Vojvodina, Pediatric Clinic, Novi Sad , Serbia
- University of Novi Sad, Faculty of Medicine, Novi Sad , Serbia
| | - Zorica Gajinov
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad , Serbia
- University of Novi Sad, Faculty of Medicine, Novi Sad , Serbia
| | - Anica Radulović
- Institute for Child and Youth Health Care of Vojvodina, Pediatric Clinic, Novi Sad , Serbia
| | - Milan Matić
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad , Serbia
- University of Novi Sad, Faculty of Medicine, Novi Sad , Serbia
| | - Aleksandra Matić
- Institute for Child and Youth Health Care of Vojvodina, Pediatric Clinic, Novi Sad , Serbia
- University of Novi Sad, Faculty of Medicine, Novi Sad , Serbia
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Udkoff J, Malicki D, Matiz C. Chronic, unilateral, and erythematous lesions on the foot of a pediatric patient - a clinicopathological challenge. Int J Dermatol 2017; 56:897-898. [PMID: 28436013 DOI: 10.1111/ijd.13635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 03/13/2017] [Accepted: 03/18/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Jeremy Udkoff
- Pediatric and Adolescent Dermatology, University of California, San Diego School of Medicine and Rady Children's Hospital, San Diego, San Diego, CA, USA
| | - Denise Malicki
- Pathology and Pediatrics, University of California, San Diego, San Diego, CA, USA.,Rady Children's Hospital, San Diego, San Diego, CA, USA
| | - Catalina Matiz
- Pediatric and Adolescent Dermatology, University of California, San Diego School of Medicine and Rady Children's Hospital, San Diego, San Diego, CA, USA.,Rady Children's Hospital, San Diego, San Diego, CA, USA
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Chuh A, Zawar V, Sciallis GF, Kempf W, Lee A. Pityriasis Rosea, Gianotti-Crosti Syndrome, Asymmetric Periflexural Exanthem, Papular-Purpuric Gloves and Socks Syndrome, Eruptive Pseudoangiomatosis, and Eruptive Hypomelanosis: Do Their Epidemiological Data Substantiate Infectious Etiologies? Infect Dis Rep 2016; 8:6418. [PMID: 27103975 PMCID: PMC4815944 DOI: 10.4081/idr.2016.6418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/24/2016] [Accepted: 02/24/2016] [Indexed: 12/21/2022] Open
Abstract
Many clinical and laboratory-based studies have been reported for skin rashes which may be due to viral infections, namely pityriasis rosea (PR), Gianotti-Crosti syndrome (GCS), asymmetric periflexural exanthem/unilateral laterothoracic exanthem (APE/ULE), papular-purpuric gloves and socks syndrome (PPGSS), and eruptive pseudo-angiomatosis (EP). Eruptive hypomelanosis (EH) is a newly discovered paraviral rash. Novel tools are now available to investigate the epidemiology of these rashes. To retrieve epidemiological data of these exanthema and analyze whether such substantiates or refutes infectious etiologies. We searched for articles published over the last 60 years and indexed by PubMed database. We then analyzed them for universality, demography, concurrent patients, temporal and spatial-temporal clustering, mini-epidemics, epidemics, and other clinical and geographical associations. Based on our criteria, we selected 55, 60, 29, 36, 20, and 4 articles for PR, GCS, APE/ULE, PPGSS, EP, and EH respectively. Universality or multiple-continental reports are found for all exanthema except EH. The ages of patients are compatible with infectious causes for PR, GCS, APE/ULE, and EH. Concurrent patients are reported for all. Significant patient clustering is demonstrated for PR and GCS. Mini-epidemics and epidemics have been reported for GCS, EP, and EH. The current epidemiological data supports, to a moderate extent, that PR, GCS, and APE could be caused by infectious agents. Support for PPGSS is marginal. Epidemiological evidences for infectious origins for EP and EH are inadequate. There might be growing epidemiological evidence to substantiate or to refute our findings in the future.
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Affiliation(s)
- Antonio Chuh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong
| | - Vijay Zawar
- Department of Dermatology, Godavari Foundation Medical College and Research Center, DUPMCJ, India
| | - Gabriel F. Sciallis
- Department of Dermatology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Werner Kempf
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - Albert Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong
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Abstract
Skin rashes that appear during febrile illnesses are in fact caused by various infectious diseases. Since infectious exanthematous diseases range from mild infections that disappear naturally to severe infectious diseases, focus on and basic knowledge of these diseases is very important. But, these include non-infectious diseases, so that comprehensive knowledge of these other diseases is required. Usually, early diagnostic testing for a febrile illness with a rash is inefficient. For clinical diagnosis of diseases accompanied by skin rash and fever, a complete history must be taken, including recent travel, contact with animals, medications, and exposure to forests and other natural environments. In addition, time of onset of symptoms and the characteristics of the rash itself (morphology, location, distribution) could be helpful in the clinical diagnosis. It is also critical to understand the patient's history of specific underlying diseases. However, diagnostic basic tests could be helpful in diagnosis if they are repeated and the clinical course is monitored. Generally, skin rashes are nonspecific and self-limited. Therefore, it could be clinically meaningful as a characteristic diagnostic finding in a very small subset of specific diseases.
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Affiliation(s)
- Jin Han Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Affiliation(s)
- Anisha George
- Department of Dermatology, Christian Medical College, Ludhiana, Punjab, India. E-mail:
| | | | - Bimal Kanish
- Department of Dermatology, Christian Medical College, Ludhiana, Punjab, India. E-mail:
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Niedermeier A, Pfützner W, Ruzicka T, Thomas P, Happle R. Superimposed lateralized exanthem of childhood: report of a case related to adenovirus infection. Clin Exp Dermatol 2015; 39:351-3. [PMID: 24635078 DOI: 10.1111/ced.12311] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2013] [Indexed: 11/29/2022]
Abstract
A 6-year-old boy developed a unilateral itchy rash, which was followed by a less severe bilateral involvement. The lesions resolved spontaneously within 4 weeks. Apparently, the rash was triggered by an adenovirus infection of the respiratory tract. Terms used currently for this disorder include 'unilateral laterothoracic exanthem' or 'asymmetrical periflexural exanthem of childhood'. The recently proposed term 'superimposed lateralized exanthem of childhood' implies the new concept that an early postzygotic mutation has rendered the skin on one side of the body more reactive to infective agents. The subsequent bilateral involvement would reflect a less severe reactivity of the contralateral keratinocytes.
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Affiliation(s)
- A Niedermeier
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany; Landeshauptstadt München, Referat für Gesundheit und Umwelt, Munich, Germany
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Affiliation(s)
- Lauren Biesbroeck
- Division of Dermatology; University of Washington School of Medicine; Seattle Washington
| | - Robert Sidbury
- Division of Dermatology; Department of Pediatrics; Seattle Children's Hospital; University of Washington School of Medicine; Seattle Washington
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Chuh A, Zawar V, Law M, Sciallis G. Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, unilateral mediothoracic exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome: a brief review and arguments for diagnostic criteria. Infect Dis Rep 2012; 4:e12. [PMID: 24470919 PMCID: PMC3892651 DOI: 10.4081/idr.2012.e12] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 11/14/2011] [Accepted: 11/14/2011] [Indexed: 12/11/2022] Open
Abstract
Several exanthems including Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome are suspected to be caused by viruses. These viruses are potentially dangerous. Gianotti-Crosti syndrome is related to hepatitis B virus infection which is the commonest cause of hepatocellular carcinoma, and Epstein-Barr virus infection which is related to nasopharyngeal carcinoma. Pityriasis rosea has been suspected to be related to human herpesvirus 7 and 8 infections, with the significance of the former still largely unknown, and the latter being a known cause of Kaposi's sarcoma. Papular-purpuric gloves and socks syndrome is significantly associated with human B19 erythrovirus infection which can lead to aplastic anemia in individuals with congenital hemoglobinopathies, and when transmitted to pregnant women, can cause spontaneous abortions and congenital anomalies. With viral DNA sequence detection technologies, false positive results are common. We can no longer apply Koch's postulates to establish cause-effect relationships. Biological properties of some viruses including lifelong latent infection, asymptomatic shedding, and endogenous reactivation render virological results on various body tissues difficult to interpret. We might not be able to confirm or refute viral causes for these rashes in the near future. Owing to the relatively small number of patients, virological and epidemiology studies, and treatment trials usually recruit few study and control subjects. This leads to low statistical powers and thus results have little clinical significance. Moreover, studies with few patients are less likely to be accepted by mainstream dermatology journals, leading to publication bias. Aggregation of data by meta-analyses on many studies each with a small number of patients can theoretically elevate the power of the results. Techniques are also in place to compensate for publication bias. However, these are not currently feasible owing to different inclusion and exclusion criteria in clinical studies and treatment trials. The diagnoses of these rashes are based on clinical assessment. Investigations only serve to exclude important differential diagnoses. A wide spectrum of clinical features is seen, and clinical features can vary across different populations. The terminologies used to define these rashes are confusing, and even more so are the atypical forms and variants. Previously reported virological and epidemiological results for these rashes are conflicting in many aspects. The cause of such incongruence is unknown, but low homogeneity during diagnosis and subject recruitment might be one of the factors leading to these incongruent results. The establishment and proper validation of diagnostic criteria will facilitate clinical diagnosis, hasten recruitment into clinical studies, and allow results of different studies to be directly compared with each another. Meta-analyses and systematic reviews would be more valid. Diagnostic criteria also streamline clinical audits and surveillance of these diseases from community perspectives. However, over-dependence on diagnostic criteria in the face of conflicting clinical features is a potential pitfall. Clinical acumen and the experience of the clinicians cannot be replaced by diagnostic criteria. Diagnostic criteria should be validated and re-validated in response to the ever-changing manifestations of these intriguing rashes. We advocate the establishment and validation of diagnostic criteria of these rashes. We also encourage the ongoing conduction of studies with a small number of patients. However, for a wider purpose, these studies should recruit homogenous patient groups with a view towards future data aggregation.
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Affiliation(s)
- Antonio Chuh
- School of Public Health, The Chinese University of Hong Kong and The Prince of Wales Hospital, Hong Kong
| | | | - Michelle Law
- School of Public Health, The Chinese University of Hong Kong and The Prince of Wales Hospital, Hong Kong
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Abstract
We report on a boy with a sudden onset of unilateral skin lesions following tonsillar infection with fever 2 weeks before. The lesions consisted of erythematous macules with scaling affecting trunk, axillar, as well as inguinal region. CRP, blood differential, serum IgG and IgM antibodies (coxsackievirus, cytomegalovirus, parvovirus, herpes virus, varicella zoster virus, human herpesvirus-6/-7), and lesional swabs (bacteria, dermatophytes, yeasts) were uneventful.
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Abstract
We report the case of a 4-year-old boy who presented with a transient extensive eczematous eruption on the left side of his trunk and extremities, with clear demarcation in the midline. The eruption started to resolve without any sequelae in 4 weeks. The history and clinical findings suggest that this transient eruption could have been either a case of unilateral blaschkitis in childhood or asymmetric periflexural exanthem.
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Affiliation(s)
- Bavani Arun
- University Hospitals of North Staffordshire NHS Trust, Department of Dermatology, Hartshill, Stoke-on-Trent, UK.
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Abstract
Unilateral laterothoracic exanthem is a self-limited disease that occurs most commonly in children. It is characterized by unilateral exanthem, often in axillary region. The etiology is unknown, but a viral agent is suspected. We report a 1-year-old white girl with unilateral laterothoracic exanthem associated with Epstein Barr virus infection, suggesting this virus has a possible etiologic role.
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Clyti E, Elloumi Y, Sainte-Marie D, Domergue V, Couppié P. Exanthème aigu infantile. Ann Dermatol Venereol 2007; 134:577-8. [PMID: 17657191 DOI: 10.1016/s0151-9638(07)89276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- E Clyti
- Service de Dermatologie, Centre Hospitalier de Cayenne, BP 6006, 97306 Cayenne.
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Abstract
Many viral infections exhibit cutaneous lesions. Recognition of the exanthems associated with these infections and the broader clinical scenarios in which they occur can lead to more rapid diagnosis and appropriate treatment for affected patients.
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Affiliation(s)
- Jonathan A Dyer
- Department of Dermatology, University of Missorui, Columbia, MO, USA.
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Reinerth G, Bruch-Gerharz D, Gerber PA, Kruse R, Neumann NJ. [Unilateral laterothoracic exanthema]. Hautarzt 2006; 57:909-10. [PMID: 16957959 DOI: 10.1007/s00105-006-1213-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- G Reinerth
- Hautklinik der Heinrich-Heine-Universität, Moorenstrasse 5, 40225 , Düsseldorf, Deutschland
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Núñez Giralda AI. [Asymmetric periflexural exanthema: apropos of a case]. An Pediatr (Barc) 2005; 63:269-70. [PMID: 16219287 DOI: 10.1157/13078472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Chamlin SL. A 25-month-old girl with progressive pruritic eruptions. Pediatr Ann 2005; 34:346, 348. [PMID: 15948345 DOI: 10.3928/0090-4481-20050501-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sarah L Chamlin
- Division of Dermatology, Children's Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Auvin S, Imiela A, Cuvellier JC, Catteau B, Vallée L, Martinot A. Asymmetric periflexural exanthem of childhood in a child with axonal Guillain-Barre syndrome. Br J Dermatol 2004; 150:396-7. [PMID: 14996133 DOI: 10.1111/j.1365-2133.2003.05798.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nahm WK, Paiva C, Golomb C, Badiavas E, Laws R. Asymmetric periflexural exanthem of childhood: a case involving a 4-month-old infant. Pediatr Dermatol 2002; 19:461-2. [PMID: 12383109 DOI: 10.1046/j.1525-1470.2002.00209.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Viral exanthems are common in childhood and account for a large number of patient visits to pediatric or family medicine clinics. Most exanthems are virtually harmless to the healthy child, but others can be signs of more significant systemic disease. Some exanthems that are benign or self-limited in the healthy child may propose significant risk to pregnant or immunocompromised individuals. Therefore, recognition of exanthems, which may be associated with certain viral illnesses, is important for the primary care provider. For example, prompt recognition of a viral exanthem caused by parvovirus may allow a pregnant female from exposing her fetus to a potentially fatal infection, or, if the exposure has already occurred, may indicate the need for appropriate fetal monitoring. In this manuscript, we review the recent literature pertaining to four characteristic exanthems that are thought to be viral in nature: papular purpuric gloves and socks syndrome; pityriasis rosea; unilateral lateral thoracic exanthem; and Gianotti-Crosti syndrome.
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Affiliation(s)
- J S Nelson
- Department of Dermatology, University of Iowa Health Care, Iowa City 52242, USA.
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Coustou D, Masquelier B, Lafon ME, Labrèze C, Roul S, Bioulac-Sage P, Mégraud F, Fleury HJ, Taïeb A. Asymmetric periflexural exanthem of childhood: microbiologic case-control study. Pediatr Dermatol 2000; 17:169-73. [PMID: 10886745 DOI: 10.1046/j.1525-1470.2000.01745.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Our objective was to study possible etiologic factors of asymmetric periflexural exanthem of childhood (APEC) among a large panel of microbiologic agents not yet investigated. To do so, we designed a prospective case-control study using throat, stool, blood, and skin samples, and enlisted 37 children with APEC and 37 age-matched controls without eruption seen consecutively from February 1995 to April 1996 from a mixed referral center and community-based population. No interventions were done. Used as the main outcome measure was the differences in the two groups for microbiologic investigations. No significant statistical differences between cases and controls for virus and bacteria investigated were found. No microorganism was identified as a possible etiologic agent in any of the APEC patients. APEC is not a nonspecific cutaneous eruptive pattern to several common microbiologic agents. More sophisticated molecular approaches are needed to address its etiology.
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Affiliation(s)
- D Coustou
- Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-Bordeaux, Bordeaux, France
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Abstract
Three cases of unilateral pigmented purpuric eruption (UPPE) occurring in children aged between 7 and 12 years are reported. The lesions were asymptomatic and occurred on the lower limb and torso; one case demonstrated a quadrantic configuration with a sharp midline cutoff. The purpuric component resolved spontaneously within 3 months in all cases, while pigmentation showed partial resolution in the two cases followed up for 12 months. Our cases support previous reports of UPPE being a benign self-limiting condition mainly affecting young patients. The cause is unknown.
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Affiliation(s)
- A Mar
- Skin and Cancer Foundation, Carlton, Victoria, Australia
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31
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Drago F, Semino M, Rampini P, Rebora A. Parvovirus B19 infection associated with acute hepatitis and a purpuric exanthem. Br J Dermatol 1999; 141:160-1. [PMID: 10417538 DOI: 10.1046/j.1365-2133.1999.02943.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Affiliation(s)
- A J Mancini
- Northwestern University Medical School, Children's Memorial Hospital, Chicago, IL 60614, USA
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Pride HB. Pediatric dermatoses commonly seen, uncommonly recognized. Pediatr Ann 1998; 27:129-35. [PMID: 9568619 DOI: 10.3928/0090-4481-19980301-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- H B Pride
- Department of Dermatology, Penn State Geisinger Health System, Danville, Pennsylvania 17822-1406, USA
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Gutzmer R, Herbst RA, Kiehl P, Kapp A, Weiß J. Unilateral laterothoracic exanthem (asymmetrical periflexural exanthem of childhood): Report of an adult patient. J Am Acad Dermatol 1997. [DOI: 10.1016/s0190-9622(18)30754-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Gutzmer R, Herbst RA, Kiehl P, Kapp A, Weiss J. Unilateral laterothoracic exanthem (asymmetrical periflexural exanthem of childhood): report of an adult patient. J Am Acad Dermatol 1997; 37:484-5. [PMID: 9308566 DOI: 10.1016/s0190-9622(97)70152-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- R Gutzmer
- Department of Dermatology, Hannover Medical School, Germany
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Abstract
The childhood exanthems include a spectrum of common and uncommon disorders caused by a variety of pathogens. In this article, timely issues relating to immunization for measles and varicella are discussed. Recently reported exanthematous illnesses, including papular-purpuric gloves and socks syndrome, unilateral laterothoracic exanthem, and eruptive pseudo-angiomatosis, are described. The current research and debate about bacterial toxins as the cause of Kawasaki syndrome are presented.
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Affiliation(s)
- S D Resnick
- Division of Dermatology, Bassett Healthcare, Cooperstown, New York, USA
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