Thinking of perianal dermatitis Introducción: la dermatitis perianal es una entidad infradiagnosticada, habitualmente producida por el estreptococo β-hemolítico del grupo A (EBHGA). La epidemiología, clínica y complicaciones están ampliamente descritas en la bibliografía. El diagnóstico es microbiológico y el tratamiento de elección asocia antibioterapia oral y tópica. Objetivo: describimos el cuadro clínico y manejo de seis pacientes para mejorar el índice de sospecha clínico. Serie de casos: seis pacientes (cinco varones). Edades: de nueve meses a cinco años (media de tres años). Clínica: seis con eritema perianal, tres con dolor defecatorio, dos con prurito, una con vaginitis. Se realizó una detección rápida de antígeno estreptocócico en cinco pacientes, de los que cuatro eran positivos inicialmente. En todos se recogió frotis rectal y en todos los cultivos creció EBHGA. Recibieron todos antibiótico oral (cinco penicilina y uno amoxicilina), asociando en cuatro mupirocina y en tres clotrimazol tópicos. Evolución satisfactoria. Discusión: los casos descritos concuerdan clínica y epidemiológicamente con la bibliografía. Es necesaria la sospecha clínica y el test rápido para el diagnóstico y tratamiento precoces. Introduction: perianal dermatitis is a misdiagnosed entity usually caused by group A beta-hemolytic streptococci (GABHS). Epidemiology, symptoms and complications are widely described in literature. The diagnosis is microbiological and the association of oral and topic antibiotic is the first choice of treatment. Objectives: we report the symptoms and management of six patients in order to improve the degree of clinical suspicion. Case-Series: patients: 6 (5 males). Ages: 9 months to 5 years (mode 3 years). Clinical presentation: 6 perianal rash, 3 rectal pain, 2 itching, 1 vaginitis. A rapid streptococcal test was done in 5 patients, 4 were initially positive. A rectum smear was taken in all patients, all of them showed GABHS growing. All patients were treated with oral antibiotic (5 penicillin, 1 amoxicillin), topic mupirocine was associated in 4 and clotrimazol in 3 patients. Satisfactory evolution. Discussion: the cases showed are clinical and epidemiologically concordant with the literature. Clinical suspicion and a rapid streptococcal test are necessary to get an early diagnosis and treatment.
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