Perineal eruption as an early sign of Kawasaki disease

Kawasaki Disease can present as a diagnostic problem at the early stage of the disease. An interesting and distinctive perineal eruption which appeared early in the course of the disease had been reported recently but sporadically in the medical literature. We reported seven patients with Kawasaki Disease who had this perineal eruption. The rash began two to three days after the onset of fever followed by desquamation in all instances by days five to seven. When compared with other signs of Kawasaki Disease, this rash appeared early. In an earlier study done in the department, the diagnosis of Kawasaki Disease was made on an average of nine days after the onset of fever. This has an important implication as early treatment had been shown to decrease the incidence of coronary arteriectasia which is the most important complication of this disease. We believe that this distinctive perineal eruption is a valuable early clinical finding which may facilitate early diagnosis and treatment of Kawasaki Disease and unless one is aware and actively looked for the perineal eruption, this early sign may be completely missed.