Liao Yi-Chen, Lee Julia Yu-Yun
Department of Dermatology, Chi-Mei Hospital, Tainan, Taiwan.
Dermatol Online J. 2009 Nov 15;15(11):10.
Kawasaki disease (KD) or mucocutaneous lymph node syndrome is a systemic vasculitis of unknown etiology affecting young children. Typical cutaneous manifestations of KD are polymorphous, including maculopapular or morbilliform rash and erythroderma. Occurrence of psoriasis following KD is rare. Herein we report a case of new onset of psoriasis in a 3-month-old that flared after a typical clinical case of KD, manifesting spiking fever, diffuse redness and fissuring of the lips, bilateral conjunctiva injection, injected throat, left cervical lymphadenopathy, erythema and desquamation of the lips, cheeks, hands, feet and perianal area, and a generalized maculopapular eruption. In addition, erythema and induration of the BCG vaccination site and coronary artery dilatation were noted. After fading of the initial rash, the patient developed widespread psoriasiform papules and plaques involving the face and extremities. The cheeks, lips and nail involvement with subunqual hyperkeratosis and pincer nail deformity were particularly striking. The diagnosis of psoriasis was confirmed by skin biopsy. The eruption resolved after one month of topical momentasone furoate treatment. The role of superantigens in KD-associated psoriasis is discussed.
川崎病（KD）或皮肤黏膜淋巴结综合征是一种病因不明的全身性血管炎，主要影响幼儿。KD的典型皮肤表现具有多形性，包括斑丘疹或麻疹样皮疹以及红皮病。KD后发生银屑病的情况罕见。在此，我们报告一例3个月大的患儿，在典型的KD临床病例后出现银屑病新发，表现为高热、嘴唇弥漫性发红和皲裂、双侧结膜充血、咽喉充血、左颈淋巴结肿大、嘴唇、脸颊、手、脚和肛周区域红斑及脱屑，以及全身性斑丘疹。此外，还注意到卡介苗接种部位出现红斑和硬结以及冠状动脉扩张。初始皮疹消退后，患者面部和四肢出现广泛的银屑病样丘疹和斑块。脸颊、嘴唇和指甲受累伴不等程度的角化过度和钳状甲畸形尤为明显。皮肤活检确诊为银屑病。外用糠酸莫米松治疗1个月后皮疹消退。本文讨论了超抗原在KD相关银屑病中的作用。
