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PHOTO ROUNDS FRIDAY
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The diagnosis
This patient had a typical case of infantile acropustulosis, which is often misdiagnosed as scabies. This intensely pruritic, vesiculopustular disease of young children is rare, and typically begins in the second or third months of life, though it can begin when the patient is 10 months old. It occurs slightly more often in darker skinned patients and in boys, can be recurrent, and typically remits when the child is 6 to 36 months of age.
It’s unclear what causes acropustulosis, though some speculate that it is a persistent reaction to scabies (“postscabies syndrome”). Oral antihistamines may be helpful in controlling pruritus. Pramoxine (lotion or cream) may be used topically to control itching as it works by a different mechanism than antihistamine. Corticosteroids (topical and oral) are generally not effective.
We reassured the mother that the condition is not dangerous and would go away on its own. We told her to return with her son if the pustular eruption significantly worsened.
This case was adapted from: Shedd A, Usatine R. Pustular diseases of childhood. In: Usatine R, Smith M, Mayeaux EJ, Chumley H, Tysinger J, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009: 432-434.
To learn more about The Color Atlas of Family Medicine, see:
* http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
* http://www.mhprofessional.com/product.php?isbn=0071474641
PHOTO ROUNDS FRIDAY
| Click to see full size image |
The diagnosis
This patient had a typical case of infantile acropustulosis, which is often misdiagnosed as scabies. This intensely pruritic, vesiculopustular disease of young children is rare, and typically begins in the second or third months of life, though it can begin when the patient is 10 months old. It occurs slightly more often in darker skinned patients and in boys, can be recurrent, and typically remits when the child is 6 to 36 months of age.
It’s unclear what causes acropustulosis, though some speculate that it is a persistent reaction to scabies (“postscabies syndrome”). Oral antihistamines may be helpful in controlling pruritus. Pramoxine (lotion or cream) may be used topically to control itching as it works by a different mechanism than antihistamine. Corticosteroids (topical and oral) are generally not effective.
We reassured the mother that the condition is not dangerous and would go away on its own. We told her to return with her son if the pustular eruption significantly worsened.
This case was adapted from: Shedd A, Usatine R. Pustular diseases of childhood. In: Usatine R, Smith M, Mayeaux EJ, Chumley H, Tysinger J, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009: 432-434.
To learn more about The Color Atlas of Family Medicine, see:
* http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
* http://www.mhprofessional.com/product.php?isbn=0071474641
PHOTO ROUNDS FRIDAY
| Click to see full size image |
The diagnosis
This patient had a typical case of infantile acropustulosis, which is often misdiagnosed as scabies. This intensely pruritic, vesiculopustular disease of young children is rare, and typically begins in the second or third months of life, though it can begin when the patient is 10 months old. It occurs slightly more often in darker skinned patients and in boys, can be recurrent, and typically remits when the child is 6 to 36 months of age.
It’s unclear what causes acropustulosis, though some speculate that it is a persistent reaction to scabies (“postscabies syndrome”). Oral antihistamines may be helpful in controlling pruritus. Pramoxine (lotion or cream) may be used topically to control itching as it works by a different mechanism than antihistamine. Corticosteroids (topical and oral) are generally not effective.
We reassured the mother that the condition is not dangerous and would go away on its own. We told her to return with her son if the pustular eruption significantly worsened.
This case was adapted from: Shedd A, Usatine R. Pustular diseases of childhood. In: Usatine R, Smith M, Mayeaux EJ, Chumley H, Tysinger J, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009: 432-434.
To learn more about The Color Atlas of Family Medicine, see:
* http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
* http://www.mhprofessional.com/product.php?isbn=0071474641