Punched-out erosions with scalloped borders: Group A Streptococcal pustulosis
Leila H Shayegan1, Lindsey E Richards2, Kimberly D Morel3
1Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
Insights
Severe atopic dermatitis in infants can present with bacterial skin infections that mimic viral conditions. Early, broad diagnostic workups are crucial for accurate treatment of Streptococcus pyogenes infections.
Area of Science:
- Pediatric Dermatology
- Infectious Diseases
- Microbiology
Background:
- Atopic dermatitis (eczema) is a chronic inflammatory skin condition common in infants.
- Infants with atopic dermatitis are susceptible to secondary bacterial and viral skin infections.
- Differentiating between bacterial and viral infections can be challenging due to overlapping clinical presentations.
Abstract:
We present a case of an infant with severe atopic dermatitis infected with Streptococcus pyogenes who presented with pustules, honey-colored crusts, and punched-out erosions with scalloped borders mimicking eczema herpeticum or eczema coxsackium. We draw attention to this case to highlight the similar clinical appearance between bacterial and viral infections in the setting of atopic dermatitis and the importance of a broad workup and coverage while awaiting results.
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