Papular Acrodermatitis of Childhood Associated with Hepatitis A Virus Infection

A 2-year-old girl developed an erythematous papular eruption on her face and extremities a week after an epidemic of hepatitis A had occurred in her school. Clinical and laboratory signs of acute hepatitis, together with serologic verification, confirmed hepatitis A infection. That diagnosis should be considered in the etiology of papular acrodermatitis of childhood.     

Some Ultrastructural Aspects of Lymph-Node Cells and Hepatocytes in Papular Acrodermatitis of Childhood

Ultrastructural examination of the inguinal lymph-nodes of six patients with papular acrodermatitis of childhood with hepatitis B antigenemia showed the presence of several Langerhans cells and, in three cases, the presence of some mononucleate cells, the cytoplasm of which contained groups of 20-50 spherical particles, approximately 150 A in diameter and with an electron-dense core. In the hepatocytes of two of these patients we observed spherical particles ranging in size between 150 A and 220 A, having an electron-lucent core and scattered throughout areas limited by a membrane.     

Papular acrodermatitis of childhood: the Gianotti-Crosti syndrome

Papular acrodermatitis of childhood (PAC), also known as Gianotti-Crosti syndrome, is a self-limited disorder with acute onset generalized lymphadenopathy and monomorphic lentil-sized, dense, nonconfluent, symmetric, flat-topped, non-pruritic papules. We describe 2 patients, one with anicteric hepatitis, lymphocytosis, and positive hepatitis B surface antigenemia, and the other with a cytomegalovirus (CMV) infection.     

Atopic Background of a Recurrent Papular Eruption of Childhood (Frictional Lichenoid Eruption)

Thirty-five children affected by a recurrent summer and spring papular eruption on the elbows, knees, and backs of the hands were examined retrospectively in order to evaluate the frequency of atopy. It was found that 45.7% were suffering from atopic diseases (atopic eczema, allergic rhinitis, asthma). This high proportion confirms the fact that an underlying atopy may predispose to the occurrence of this dermatosis.     

Acrodermatitis chronica atrophicans. (Herxheimer-Hartmann)

Ohne Zusammenfassung     

Papular mucinosis (discrete papular lichen myxedematosus)

A 56-year-old woman presented with small, skin-colored papules on the trunk and thighs. Histopathologic findings were consistent with papular mucinosis. Laboratory evaluation did not show an associated paraproteinemia. Treatment with topical glucocorticoids was unsuccessful. Papular mucinosis, also known as localized lichen myxedematosus, has been categorized into 4 subtypes. The discrete papular form, as seen in our patient, is characterized by a few to multiple, 2-5-mm, skin-colored, firm, waxy, dome-shaped papules on the trunk and proximal aspects of the extremities. By definition there is no associated paraproteinemia, but this form may be associated with human immunodeficiency virus infection. Focal or diffuse mucinous deposits are seen on histopathologic examination. The usual clinical course is slow cutaneous progression without spontaneous resolution. Treatment is empiric and is usually unsuccessful.     

Gianotti-Crosti syndrome associated with hepatitis B surface antigen (subtype adr)

The Gianotti-Crosti syndrome, papular acrodermatitis of childhood (PAC), is an infrequently recognized disorder with distinctive characteristics. At present hepatitis B virus is thought to be an etiologic agent. The disease is very rare in Korea, in spite of the high frequency of hepatitis B surface antigen (HBsAg) in the general population. It is known that subtype ayw of the HBsAg may influence the pathogenesis of PAC, but subtype analysis of HBsAg in these patients disclosed adr. Therefore, our studies reconfirmed that PAC may in addition be associated with subtype adr of HBsAg. We believe that the lower incidence of PAC in Korea as compared with the high incidence of PAC in other parts of the world, such as in the Mediterranean area, may be due to the fact that a higher predisposition to PAC is conferred by subtype ayw of HBsAg.     

Eosinophilic Pustular Folliculitis (Ofuji Disease) in Childhood: A Review of Four Cases

Four children under 2 years of age were treated at our hospital in the last three years with a recurrent vesiculopustular eruption of the scalp, variably extending to the face and limbs. All cases followed a cyclical pattern. Three of the children had a moderate response to topical steroids, and one went into remission after a two-month course of erythromycin. Ethnic origin may be an important predisposing factor. Histologically, all patients showed a moderate mixed inflammatory infiltrate with numerous eosinophils centered around hair follicles. Peripheral white blood cell count showing leukocytosis with eosinophilia was observed in those cases measured, but no consistent immunologic abnormalities could be identified.     

Childhood Lichen Planus (LP)

In adults, lichen planus (LP) is relatively more common than in children. Among 222 cases of LP, there were 25 (11.2%) children in our study. The majority of the cases were females in the age group of 8–14; the youngest child was 3 years old. Papular and linear types of LP were common in children. There was no familial history of LP in any of the cases. The patients with classic LP lesions responded well to dapsone therapy. This study supports the suggestion of Ramsay and Hurley that childhood LP is more common in the tropics.