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Asymmetric periflexural exanthem of childhood: a clinical, pathologic, and epidemiologic prospective study
D Coustou1, C Léauté-Labrèze, P Bioulac-Sage
1Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-Enfants, Bordeaux, France.
Objective:
To assess the clinical, pathologic, and epidemiologic features of asymmetric periflexural exanthem of childhood (APEC), a clinically distinctive eruption, especially its link with pityriasis rosea and pattern of transmission.
Design:
A prospective case series, including an analysis of epidemiologic triggering factors and mode of transmission. Pathologic study, including immunohistochemistry of the inflammatory infiltrate.
Setting:
A mixed, community-based referral center.
Patients:
A total of 37 girls and 30 boys with typical APEC referred from April 1994 to December 1996 were included in the study; 82% came from the greater Bordeaux area in France.
Intervention:
None.
Main Outcome Measure:
Possible interhuman transmission of APEC.
Results:
[corrected] No triggering factor was identified; no interhuman transmission occurred; and no demonstrable link with pityriasis rosea was apparent. Several new clinical variants were recognized or confirmed (high fever, facial and peripheral involvement, prolonged course). Distinctive perisudoral interface CD8+ infiltrate was suggestive of diagnosis.
Conclusions:
Interhuman transmission was doubtful, but inoculation disorder was still possible. Histopathologic findings seem more specific than previously thought.