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Updates on postinfectious skin rashes in pediatric dermatology
Samantha Shwe Daniel1, Caitlin Peterman, Smita Awasthi
1Department of Dermatology and Pediatrics, University of California, Davis, California, USA.
Insights
Recent literature highlights pediatric postinfectious skin rashes, including COVID-19-related conditions like multisystem inflammatory syndrome in children (MIS-C) and Gianotti-Crosti syndrome-like reactions. Updates also cover staphylococcal scalded skin syndrome management and antifungal resistance.
Area of Science:
- Pediatric Dermatology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic has influenced the landscape of pediatric infectious skin rashes.
- Understanding emerging and evolving dermatological manifestations in children is crucial.
Purpose of the Study:
- To provide an updated review of postinfectious skin rashes in pediatric populations based on recent literature.
- To inform clinicians about new diagnoses and management strategies.
Main Methods:
- Literature review of recently published studies on pediatric infectious skin rashes.
- Synthesis of findings related to COVID-19 sequelae and other infectious dermatoses.
Main Results:
- COVID-19 is associated with multisystem inflammatory syndrome in children (MIS-C) and reactive infectious mucocutaneous eruption (RIME).
- Papular acrodermatitis of childhood (Gianotti-Crosti) has been linked to SARS-CoV-2 and other viral infections.
- Newer evidence supports beta-lactam monotherapy for staphylococcal scalded skin syndrome (SSSS) and highlights concerns regarding antifungal resistance (Trichophyton indotinae).
Conclusions:
- Clinicians must be aware of newly recognized diagnoses associated with the COVID-19 pandemic.
- Updated evidence-based recommendations for managing various postinfectious skin conditions are essential for pediatric care.
Purpose Of Review:
This review provides updates on postinfectious skin rashes in the pediatric population from recently published literature.
Recent Findings:
The COVID-19 pandemic and its sequelae remain a focus of research on pediatric infectious skin rashes. Multisystem inflammatory syndrome in children (MIS-C) and reactive infectious mucocutaneous eruption (RIME) are common complications of infection with SARS-COV-2 in the pediatric population. Most cases of MIS-C show low mortality and suggest mucocutaneous symptoms do not correlate with COVID-19 disease severity. Cases of papular acrodermatitis of childhood, also known as Gianotti-Crosti, have also been reported in association with SARS-COV-2, and can present similarly in reaction to other viral infection like molluscum contagiosum, known as a Gianotti-Crosti syndrome-like reaction (GCLR). Other relevant studies on postinfectious skin rashes include updates on the management of staphylococcal scalded skin syndrome (SSSS), with newer evidence advocating for beta-lactam monotherapy without clindamycin and reduced ancillary testing. Finally, the emergence of antifungal resistance due to Trichophyton indotinae is a growing global health concern emphasizing the need for improved antifungal stewardship.
Summary:
It is prudent for clinicians to be informed of both common and rare diagnoses that have emerged more recently in association with the COVID-19 pandemic, in addition to other diseases with newer evidence-based recommendations to guide management.
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