Disease Information for Acropustulosis of infancy

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Clinical Manifestations
Signs & Symptoms
Rash hand/foot areas
Vesicobullous rash/lesions in Children
Vesicobullous rashes
Constitutional symptoms
Definition

Acropustulosis of infancy; Infantile acropustulosis is a recurrent, self-limited, pruritic, vesicopustular eruption of the palms and the soles occurring in young children during the first 2-3 years of life; Newly described in 1979, it is probably much more common than the scarcity of reports would imply; The pathophysiology of infantile acropustulosis is unknown; Many cases are preceded by well-documented or suspected scabies infestation, and a scabies id reaction has been suggested; More often, cases occur despite scabies having been thoroughly ruled out; Bacterial and viral culture results are consistently negative, and negative immunofluorescence results suggest that infantile acropustulosis is not an antibody-mediated autoimmune process; The exact incidence is unknown. One study from Israel reported 25 cases in a 9-year period, suggesting that this is not as uncommon as once thought;

Mortality/Morbidity: All cases spontaneously resolve in a few months to 3 years; Although children as old as 9 years have been reported, acropustulosis typically begins between the first 2-12 months of life; Resolution by age 3 years is the norm.

Classically, an infant aged 2-12 months develops pruritic erythematous macules or papules that progress into vesicles and then pustules; Children are fretful, irritable, and obviously uncomfortable, but otherwise healthy;

Individual bouts last 7-15 days and recur in 2- to 4-week intervals;often have been empirically treated with antiscabies medicines prior to presentation;

The intensity and the duration of attacks diminish with each recurrence; The hands and the feet are always involved, usually on the palms, the soles, and the lateral surfaces; Lesions may occur on the dorsal aspects of the hands and the feet as well as the trunk, the scalp, and the face; Lesions begin as small macules or papules that then form distinct, noncoalescing vesicles and pustules; They heal with macular hyperpigmentation; No other organ systems are involved

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NEJM (The New England Journal of Medicine)
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