Febrile Perianal Streptococcal Dermatitis

Vélez, Antonio; Moreno, José-Carlos

doi:10.1046/j.1525-1470.1999.99006.x

Cited by 16 publications

(11 citation statements)

References 14 publications

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“…Another cutaneous finding, acral desquamation (following therapy for PID caused by GAS and concomitant with resolution of PID) was reported by three authors; these included fingers[42,46,49], toes[42], and perioral skin[49]. The presence of acral desquamation has been suggested to be the effect of streptococcal exotoxin[42,46,49]. Rarely, when PID is diagnosed early, concomitant pharyngitis may be found[6,21,22,25].…”

Section: Clinical Presentationmentioning

confidence: 96%

“…However, the main reason for this unknown incidence is considered the fact that PID remains too often unrecognized by healthcare professionals. PID appears all over the world and has been reported by authors in various countries from different continents, including the United States[2,4,5,23,25,26,28,32,38,43,46,57,59,61-63], Canada[3,20,40], Australia[11,33], Africa (Egypt[15]), Europe (United Kingdom[7,10,29,30,65], Spain[6,19,21,31,42,64], Italy[22,35,39,47,48], The Netherlands[36,60], Finland[37], Sweden[41,50], Germany[8,9,45], Denmark[27], Switzerland[12,17,54], France[13,16,55], Greece[58]), Asia (India[44], Taiwan[49], Japan[51,52], Iran[56]), Israel[14,18] and Turkey[53]. It appears that no cases have been published from Eastern Europe.…”

Section: Epidemiologymentioning

confidence: 99%

“…Infection can extend to genital organs, resulting in vulvo-vaginitis[2,3,5,6,13,16,21-23,43,47,50,57,65] or balanitis[3,22,23,29,33,42,45,50,64], and cultures from these areas grow same type of bacteria[2,22,29]. Small papules or pustules on the buttocks are suggestive for S. aureus [26,32].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Sometimes, extraperineal rash (mostly papulo-pustular or impetiginous) could also be associated, up to 35.8% in a recent series[25]. Another cutaneous finding, acral desquamation (following therapy for PID caused by GAS and concomitant with resolution of PID) was reported by three authors; these included fingers[42,46,49], toes[42], and perioral skin[49]. The presence of acral desquamation has been suggested to be the effect of streptococcal exotoxin[42,46,49].…”

Section: Clinical Presentationmentioning

confidence: 99%

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Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition

Serban

2018

WJCP

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Perianal infectious dermatitis (PID) represents a superficial inflammation of the perianal skin, which is of bacterial origin (classically, group A beta-hemolytic streptococci). This narrative review aims to critically review and summarize the available scientific literature regarding pediatric PID, being the first of its kind, to the best of the author’s knowledge. It also reports the first cases of Romanian children with PID. Multiple databases were subjected to systematic literature search (from 1966 to April 30, 2018) to identify studies and case reports of children with PID. As such, this review provides updated information about essential aspects of PID (epidemiology, etiology, pathogenesis, as well as clinical features, required investigations and therapeutic options) and of diagnostic pitfalls. Although a well-defined entity, PID remains largely underdiagnosed. PID may mimic other common conditions with skin manifestations (like candidiasis, pinworms, eczema, irritant dermatitis, anal fissure, hemorrhoids, Crohn’s disease, psoriasis, seborrheic dermatitis, zinc deficiency dermatosis and even sexual abuse), with consequent unnecessary, sometimes expensive and invasive investigations and futile therapies, which cause patients and families discomfort and distress. Since PID has an unremitting course, early recognition is imperative, as it allows for prompt and efficacious antibiotic therapy. However, PID represents a stubborn condition and, even if properly treated, its recurrence rate remains high. Further well-designed prospective randomized controlled trials, with adequate follow-up, are required in order to formulate the optimum personalized antibiotic therapy (oral alone or in association with topical medication), able to prevent recurrences. Awareness of this condition by healthcare professionals should improve patient outcomes.

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Section: Clinical Presentationmentioning

confidence: 96%

Section: Epidemiologymentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

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Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition

Serban

2018

WJCP

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“…A case of PSD involving desquamation of the hands, feet, and perineum has been reported. 143 Acral desquamation is not a typical feature of PSD. Guttate psoriasis, another condition thought to be triggered by SAgs, has also been associated with PSD.…”

Section: Cutaneous T-cell Lymphomamentioning

confidence: 99%

Superantigens in dermatology

Macias

Pereira

Rietkerk

et al. 2011

Journal of the American Academy of Dermatology

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Recurrent Toxin-Mediated Perineal Erythema

Patrizi¹,

Raone²,

Savoia³

et al. 2008

Arch Dermatol

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Background: Recurrent toxin-mediated perineal erythema is a cutaneous disease mediated by superantigens made by staphylococci and streptococci, which, to our knowledge, has only been reported in young adults. We describe recurrent toxin-mediated perineal erythema in 11 children and outline the differences between recurrent toxin-mediated perineal erythema and Kawasaki disease in this age range.Observations: Eleven children (7 male and 4 female) presented with the sudden appearance of asymptomatic erythema, which was salmonlike in color and rapidly desquamating, involving the perineum in 10 patients and extending to the perianal area in 1 patient. At the onset of the rash, all patients were in good health, although 9 had mild fever for 1 to 2 days before its appearance. Physical examination also revealed an erythema of the hands and feet in 4 patients and strawberry tongue in 7. Two patients had a facial impetigo, and another showed a perianal streptococcal dermatitis. A group A ␤-hemolytic streptococcus was isolated from the throat in 10 cases and from a perianal culture in 1 case. In 8 cases, resolution was spontaneous, but all patients were treated with systemic antimicrobial therapy for 10 days. Three patients had a personal history of cutaneous rashes on the perineal area during the last years before consultation. Rash recurrence was observed in 3 of the 11 patients at the follow-up examination. Conclusion:Recurrent toxin-mediated perineal erythema can be observed not only in young adults but also in childhood

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Febrile Perianal Streptococcal Dermatitis

Cited by 16 publications

References 14 publications

Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition

Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition

Superantigens in dermatology

Recurrent Toxin-Mediated Perineal Erythema

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