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VALENCIA-HERRERA A, GANOZA-GRANADOS L, CAMARGO-SÁNCHEZ K, CHIRINO-BARCELÓ YA, TOLEDO-BAHENA M. Asymmetrical Periflexural Exanthem Associated with SARS-CoV-2 Infection in a Paediatric Patient. Acta Derm Venereol 2023; 103:adv00839. [PMID: 36172694 PMCID: PMC9885288 DOI: 10.2340/actadv.v102.3499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/12/2022] [Indexed: 01/07/2023] Open
Abstract
Abstract is missing (Short communication)
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Affiliation(s)
- Adriana VALENCIA-HERRERA
- Dermatology Service, Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Delegación Cuauhtémoc, Colonia Doctores, CP 06720 Mexico City
| | - Luciana GANOZA-GRANADOS
- Dermatology Service, Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Delegación Cuauhtémoc, Colonia Doctores, CP 06720 Mexico City
| | - Karen CAMARGO-SÁNCHEZ
- Dermatology Service, Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Delegación Cuauhtémoc, Colonia Doctores, CP 06720 Mexico City
| | | | - Mirna TOLEDO-BAHENA
- Dermatology Service, Hospital Infantil de México Federico Gómez, Doctor Márquez 162 Delegación Cuauhtémoc, Colonia Doctores, CP 06720 Mexico City,E-mail:
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Prćić S, Gajinov Z, Radulović A, Matić M, Matić A. Unilateral Laterothoracic Exanthem – Asymmetric Periflexural Exanthem of Childhood – a Case Report and Literature Review. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2018. [DOI: 10.1515/sjdv-2017-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Unilateral laterothoracic exanthem (ULE), or asymmetric periflexural exanthem of childhood (APEC), is an uncommon skin eruption that usually occurs in childhood, with unilateral distribution and self limiting course. The etiology of ULE is unknown, but viral cause is suspected. We report a case of ULE in a 4-year-old girl, that was associated with parvo virus B19 infection, and a brief selected literature review. The patient presented with unilateral maculopapular rash on the left side of the body which was asymptomatic and resolved spontaneously within 5 weeks. The clinical diagnosis of ULE may be precise, ruling out a broad spectrum of differential diagnosis, and prevent unnecessary examinations, whereas the patient is informed about the benign self-limiting nature of ULE.
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Affiliation(s)
- Sonja Prćić
- Institute for Child and Youth Health Care of Vojvodina, Pediatric Clinic, Novi Sad , Serbia
- University of Novi Sad, Faculty of Medicine, Novi Sad , Serbia
| | - Zorica Gajinov
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad , Serbia
- University of Novi Sad, Faculty of Medicine, Novi Sad , Serbia
| | - Anica Radulović
- Institute for Child and Youth Health Care of Vojvodina, Pediatric Clinic, Novi Sad , Serbia
| | - Milan Matić
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad , Serbia
- University of Novi Sad, Faculty of Medicine, Novi Sad , Serbia
| | - Aleksandra Matić
- Institute for Child and Youth Health Care of Vojvodina, Pediatric Clinic, Novi Sad , Serbia
- University of Novi Sad, Faculty of Medicine, Novi Sad , Serbia
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Chuh A, Zawar V, Sciallis GF, Kempf W, Lee A. Pityriasis Rosea, Gianotti-Crosti Syndrome, Asymmetric Periflexural Exanthem, Papular-Purpuric Gloves and Socks Syndrome, Eruptive Pseudoangiomatosis, and Eruptive Hypomelanosis: Do Their Epidemiological Data Substantiate Infectious Etiologies? Infect Dis Rep 2016; 8:6418. [PMID: 27103975 PMCID: PMC4815944 DOI: 10.4081/idr.2016.6418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 02/24/2016] [Accepted: 02/24/2016] [Indexed: 12/21/2022] Open
Abstract
Many clinical and laboratory-based studies have been reported for skin rashes which may be due to viral infections, namely pityriasis rosea (PR), Gianotti-Crosti syndrome (GCS), asymmetric periflexural exanthem/unilateral laterothoracic exanthem (APE/ULE), papular-purpuric gloves and socks syndrome (PPGSS), and eruptive pseudo-angiomatosis (EP). Eruptive hypomelanosis (EH) is a newly discovered paraviral rash. Novel tools are now available to investigate the epidemiology of these rashes. To retrieve epidemiological data of these exanthema and analyze whether such substantiates or refutes infectious etiologies. We searched for articles published over the last 60 years and indexed by PubMed database. We then analyzed them for universality, demography, concurrent patients, temporal and spatial-temporal clustering, mini-epidemics, epidemics, and other clinical and geographical associations. Based on our criteria, we selected 55, 60, 29, 36, 20, and 4 articles for PR, GCS, APE/ULE, PPGSS, EP, and EH respectively. Universality or multiple-continental reports are found for all exanthema except EH. The ages of patients are compatible with infectious causes for PR, GCS, APE/ULE, and EH. Concurrent patients are reported for all. Significant patient clustering is demonstrated for PR and GCS. Mini-epidemics and epidemics have been reported for GCS, EP, and EH. The current epidemiological data supports, to a moderate extent, that PR, GCS, and APE could be caused by infectious agents. Support for PPGSS is marginal. Epidemiological evidences for infectious origins for EP and EH are inadequate. There might be growing epidemiological evidence to substantiate or to refute our findings in the future.
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Affiliation(s)
- Antonio Chuh
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong
| | - Vijay Zawar
- Department of Dermatology, Godavari Foundation Medical College and Research Center, DUPMCJ, India
| | - Gabriel F. Sciallis
- Department of Dermatology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Werner Kempf
- Department of Dermatology, University Hospital Zürich, Zürich, Switzerland
| | - Albert Lee
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong
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Chuh A, Zawar V, Law M, Sciallis G. Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, unilateral mediothoracic exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome: a brief review and arguments for diagnostic criteria. Infect Dis Rep 2012; 4:e12. [PMID: 24470919 PMCID: PMC3892651 DOI: 10.4081/idr.2012.e12] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 11/14/2011] [Accepted: 11/14/2011] [Indexed: 12/11/2022] Open
Abstract
Several exanthems including Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome are suspected to be caused by viruses. These viruses are potentially dangerous. Gianotti-Crosti syndrome is related to hepatitis B virus infection which is the commonest cause of hepatocellular carcinoma, and Epstein-Barr virus infection which is related to nasopharyngeal carcinoma. Pityriasis rosea has been suspected to be related to human herpesvirus 7 and 8 infections, with the significance of the former still largely unknown, and the latter being a known cause of Kaposi's sarcoma. Papular-purpuric gloves and socks syndrome is significantly associated with human B19 erythrovirus infection which can lead to aplastic anemia in individuals with congenital hemoglobinopathies, and when transmitted to pregnant women, can cause spontaneous abortions and congenital anomalies. With viral DNA sequence detection technologies, false positive results are common. We can no longer apply Koch's postulates to establish cause-effect relationships. Biological properties of some viruses including lifelong latent infection, asymptomatic shedding, and endogenous reactivation render virological results on various body tissues difficult to interpret. We might not be able to confirm or refute viral causes for these rashes in the near future. Owing to the relatively small number of patients, virological and epidemiology studies, and treatment trials usually recruit few study and control subjects. This leads to low statistical powers and thus results have little clinical significance. Moreover, studies with few patients are less likely to be accepted by mainstream dermatology journals, leading to publication bias. Aggregation of data by meta-analyses on many studies each with a small number of patients can theoretically elevate the power of the results. Techniques are also in place to compensate for publication bias. However, these are not currently feasible owing to different inclusion and exclusion criteria in clinical studies and treatment trials. The diagnoses of these rashes are based on clinical assessment. Investigations only serve to exclude important differential diagnoses. A wide spectrum of clinical features is seen, and clinical features can vary across different populations. The terminologies used to define these rashes are confusing, and even more so are the atypical forms and variants. Previously reported virological and epidemiological results for these rashes are conflicting in many aspects. The cause of such incongruence is unknown, but low homogeneity during diagnosis and subject recruitment might be one of the factors leading to these incongruent results. The establishment and proper validation of diagnostic criteria will facilitate clinical diagnosis, hasten recruitment into clinical studies, and allow results of different studies to be directly compared with each another. Meta-analyses and systematic reviews would be more valid. Diagnostic criteria also streamline clinical audits and surveillance of these diseases from community perspectives. However, over-dependence on diagnostic criteria in the face of conflicting clinical features is a potential pitfall. Clinical acumen and the experience of the clinicians cannot be replaced by diagnostic criteria. Diagnostic criteria should be validated and re-validated in response to the ever-changing manifestations of these intriguing rashes. We advocate the establishment and validation of diagnostic criteria of these rashes. We also encourage the ongoing conduction of studies with a small number of patients. However, for a wider purpose, these studies should recruit homogenous patient groups with a view towards future data aggregation.
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Affiliation(s)
- Antonio Chuh
- School of Public Health, The Chinese University of Hong Kong and The Prince of Wales Hospital, Hong Kong
| | | | - Michelle Law
- School of Public Health, The Chinese University of Hong Kong and The Prince of Wales Hospital, Hong Kong
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Dar NR, Raza N. Asymmetrical periflexural exanthem exhibiting pseudoisomorphic Köebner response in an adult. Clin Exp Dermatol 2009; 34:808-10. [DOI: 10.1111/j.1365-2230.2008.03053.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Clyti E, Elloumi Y, Sainte-Marie D, Domergue V, Couppié P. Exanthème aigu infantile. Ann Dermatol Venereol 2007; 134:577-8. [PMID: 17657191 DOI: 10.1016/s0151-9638(07)89276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- E Clyti
- Service de Dermatologie, Centre Hospitalier de Cayenne, BP 6006, 97306 Cayenne.
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Guimerá-Martín-Neda F, Fagundo E, Rodríguez F, Cabrera R, Sánchez R, García M, Sáez M, Noda A. Asymmetric periflexural exanthem of childhood: report of two cases with parvovirus B19. J Eur Acad Dermatol Venereol 2006; 20:461-2. [PMID: 16643150 DOI: 10.1111/j.1468-3083.2006.01443.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Núñez Giralda AI. [Asymmetric periflexural exanthema: apropos of a case]. An Pediatr (Barc) 2005; 63:269-70. [PMID: 16219287 DOI: 10.1157/13078472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Auvin S, Imiela A, Cuvellier JC, Catteau B, Vallée L, Martinot A. Asymmetric periflexural exanthem of childhood in a child with axonal Guillain-Barre syndrome. Br J Dermatol 2004; 150:396-7. [PMID: 14996133 DOI: 10.1111/j.1365-2133.2003.05798.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gelmetti C, Caputo R. Asymmetric periflexural exanthem of childhood: Who are you? J Eur Acad Dermatol Venereol 2001. [DOI: 10.1046/j.0926-9959.2001.00298.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gelmetti C, Caputo R. Asymmetric periflexural exanthem of childhood: Who are you? J Eur Acad Dermatol Venereol 2001. [DOI: 10.1046/j.1468-3083.2001.00298.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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