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[Pediatric papular acrodermatitis and double primary infection by the hepatitis B virus and the Epstein-Barr virus]
Insights
This study reports a rare case of papular infantile acrodermatitis in a child, linked to a dual infection with Hepatitis B virus (HBV) and Epstein-Barr virus (EBV). The findings highlight potential co-infections in pediatric inflammatory skin conditions.
Area of Science:
- Pediatric Dermatology
- Viral Hepatitis
- Immunology
Background:
- Papular infantile acrodermatitis (Gianotti-Crosti syndrome) is a benign skin condition typically seen in children.
- Etiology is often linked to viral infections, most commonly Hepatitis B virus (HBV).
- Co-infections with other viruses are less commonly reported but can complicate diagnosis.
Observation:
- A 22-month-old child presented with papular infantile acrodermatitis.
- Laboratory findings revealed cytolytic hepatitis with elevated monocytes and hyperbasophilic cells.
- The child tested positive for Hepatitis B surface antigen and IgM anti-HBc antibodies, indicating acute HBV infection.
- Epstein-Barr virus (EBV) serology confirmed a primary EBV infection.
Findings:
- The case demonstrates a co-infection of acute Hepatitis B virus and primary Epstein-Barr virus in a child with papular infantile acrodermatitis.
- The presence of hyperbasophilic monocytes suggests a significant inflammatory response.
- The absence of anti-HBs antibodies indicates a lack of protective immunity against HBV at the time of presentation.
Implications:
- This case expands the known spectrum of viral triggers for papular infantile acrodermatitis.
- It underscores the importance of considering co-infections in pediatric viral exanthems.
- Further research may elucidate the synergistic role of EBV and HBV in pediatric dermatologic manifestations.
Abstract:
A case of papular infantile acrodermatitis was evaluated in a twenty-two month-old child. Laboratory data showed the presence of a cytolytic hepatitis associated to an increase in circulating monocytes (1.500/mm3) with hyperbasophilic cells. Hepatitis B surface (HBs) antigen was detected in the serum, associated to anti-HBc antibodies of the IgM class, without detectable anti-HBs antibodies. Simultaneously, EBV serologic profiles were consistent with a primary infection. The authors review the clinical presentation of previously described cases according to their suspected cause, and discuss the etiologic role of both EBV and HBV in the hereby reported case.