Papular and papulovesicular acrolocated eruptions and viral infections

Twenty-six children with a symmetric papular or papulovesicular acrolocated eruption were studied to evaluate a possible link with viral infection. A history of a recent immunization was present in four patients, two of whom had a polio vaccine virus isolated from their stool samples. There was serologic evidence of a recent Epstein-Barr virus infection in one patient, adenovirus infection in another, a concurrent Epstein-Barr virus and adenovirus infection in a third, and cytomegalovirus infection in a fourth. Viral cultures were positive in two patients for adenovirus and in two others for rotavirus. Although some of the virologic findings could have been coincidental, this study confirms that multiple viral infections can be related to most papular and papulovesicular acrolocated eruptions of childhood. Virologic investigations in the earlier phases of the eruption are recommended to identify the etiologic factors of these lesions.