Infantile papular acrodermatitis
What is infantile papular acrodermatitis?
Infantile papular acrodermatitis is a characteristic response of the skin to viral infection in which there is a papular rash that lasts for several weeks.
Other names sometimes used for this skin condition include Gianotti-Crosti syndrome, papulovesicular acrodermatitis of childhood, papular acrodermatitis of childhood and acrodermatitis papulosa infantum.
Who gets infantile papular acrodermatitis?
As the name suggests, infantile papular acrodermatitis mainly affects children between the ages of 6 months and 12 years. However, it has rarely been described in adults.
A clustering of cases is often observed, and a preceding upper respiratory infection is common.
What causes infantile papular acrodermatitis?
The specific viruses causing infantile papular acrodermatitis include:
- Hepatitis B infection
- Epstein Barr virus (the cause of glandular fever)
- Enterovirus infections
- Echo viruses
- Respiratory syncytial virus
Vaccination has also occasionally been associated with the onset of infantile papular acrodermatitis.
What are the clinical features of infantile papular acrodermatitis?
Infantile papular acrodermatitis presents over the course of 3 or 4 days. A profuse eruption of dull red spots develops first on the thighs and buttocks, then on the outer aspects of the arms, and finally on the face. The rash is often asymmetrical.
The individual spots are 5–10 mm in diameter and are a deep red colour. Later they often look purple, especially on the legs, due to leakage of blood from the capillaries. They may develop fluid-filled blisters (vesicles).
Infantile papular acrodermatitis is not usually itchy.
The child with infantile papular acrodermatitis may feel quite well or have a mild temperature. Mildly enlarged lymph nodes in the armpits and groins may persist for months. When infantile papular acrodermatitis is caused by hepatitis B, there may be an enlarged liver, but there is seldom any jaundice.
How is infantile papular acrodermatitis diagnosed?
The clinical appearance is quite characteristic, and many children do not require any specific tests. However, blood tests may include:
- Blood count
- Liver function
- Viral serology or PCR.
What treatment is available for infantile papular acrodermatitis?
What is the outlook for infantile papular acrodermatitis?
Infantile papular acrodermatitis fades in 2–8 weeks with mild scaling. Recurrence of infantile papular acrodermatitis is unlikely but has been reported.
If hepatitis B is present, the liver takes between 6 months and 4 years to fully recover. Sometimes there is persistent hepatitis and long-term viral carriage.