Mucocutaneous lymph node syndrome without exanthema: a case report

A seven-year, eight-month-old Mexican-American boy was admitted to the hospital with a history of prolonged fever and cervical adenitis. The fever persisted for approximately two weeks and was associated with bilateral conjunctivitis, dryness and redness of the lips, and a deeply red tongue with marked hypertrophy of the papillae. Approximately two weeks following admission a peculiar desquamation of the perianal area was noted, followed by the desquamation of the hands and feet typically noted with mucocutaneous lymph node syndrome (MLNS).Numerous laboratory studies were performed and were not revealing. With the desquamation of the hands and feet a diagnosis of MLNS was believed confirmed. This case is unusual because there was no cutaneous eruption so characteristic of MLNS, and also because of the presence of the peculiar perianal desquamation which has not been previously reported.