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Recurrent toxin-mediated perineal erythema: eleven pediatric cases

Annalisa Patrizi1, Beatrice Raone, Francesco Savoia

  • 1Clinica Dermatologica Via Massarenti 1, 40138 Bologna, Italy. annalisa.patrizi@unibo.it

Archives of Dermatology
|February 20, 2008
PubMed

Insights

Recurrent toxin-mediated perineal erythema, a superantigen-mediated rash, is reported in children, not just adults. This study details its presentation and distinguishes it from Kawasaki disease in pediatric patients.

Area of Science:

  • Pediatric Dermatology
  • Infectious Diseases
  • Toxicology

Background:

  • Recurrent toxin-mediated perineal erythema (RTPE) is a rare skin condition.
  • Previously, RTPE was thought to affect only young adults.
  • It is caused by superantigens produced by staphylococci and streptococci.

Purpose of the Study:

  • To describe cases of RTPE in children.
  • To differentiate RTPE from Kawasaki disease in pediatric patients.

Main Methods:

  • Retrospective case series of 11 children with RTPE.
  • Clinical presentation, physical examination findings, and microbiological cultures were analyzed.
  • Comparison with clinical features of Kawasaki disease.

Main Results:

  • Eleven children (7 male, 4 female) presented with salmon-colored, desquamating perineal erythema.
  • Associated symptoms included fever, hand-foot erythema, strawberry tongue, and impetigo.
  • Group A beta-hemolytic streptococcus was frequently isolated.
  • Three patients experienced rash recurrence.

Conclusions:

  • Recurrent toxin-mediated perineal erythema occurs in childhood.
  • Clinical features can overlap with Kawasaki disease, necessitating careful diagnosis.
  • Prompt antimicrobial therapy is recommended.
Abstract

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