Departamento de Pediatría, Servicio de Dermatología, Hospital Escuela, Universidad Nacional Autónoma de Honduras.
Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.
Bol Med Hosp Infant Mex. 2022;79(4):268-273. doi: 10.24875/BMHIM.21000125.
Acute generalized exanthematous pustulosis is a rare disease. Although it is usually related to drug intake, it is occasionally associated with infections, especially in the pediatric age. It is characterized by the sudden onset of sterile non-follicular pustules on an erythematous fundus, fever, and leukocytosis, with frequent and prompt spontaneous resolution. It mainly affects adults and is uncommon in childhood. Complications have been reported in approximately 20% of cases.
We report the case of a 10-year-old female patient with a 5-day history of fever and dermatosis characterized by countless non-follicular pustules, predominantly on the trunk, inguinal folds, and proximal thighs but not involving palms, soles, and mucous membranes. The patient reported an incident of upper respiratory tract infection that occurred 7 days earlier. Histopathological examination confirmed the diagnosis of acute generalized exanthematous pustulosis. Spontaneous resolution occurred within 2 weeks.
This disease is one of the severe cutaneous adverse reactions that usually have a self-limited and benign course within a few weeks. We propose that a previous respiratory infection triggered the acute generalized exanthematous pustulosis in this pediatric case. Knowledge of this pathology by the medical professionals, in general, and the pediatricians, in particular, will prevent an aggressive and inappropriate approach and management.
急性泛发性发疹性脓疱病是一种罕见的疾病。虽然它通常与药物摄入有关,但偶尔也与感染有关,特别是在儿科。其特征是突然出现红斑基底上无菌非滤泡性脓疱、发热和白细胞增多,常迅速自发缓解。它主要影响成年人,在儿童中并不常见。约 20%的病例有并发症报道。
我们报告了一例 10 岁女性患者的病例,该患者发热 5 天,皮肤病变表现为数以千计的非滤泡性脓疱,主要位于躯干、腹股沟褶皱和大腿近端,但不涉及手掌、脚底和粘膜。患者报告在 7 天前有上呼吸道感染的事件。组织病理学检查证实为急性泛发性发疹性脓疱病。在 2 周内自发缓解。
本病是严重皮肤不良反应之一,通常在数周内具有自限性和良性病程。我们提出,该儿科病例中的急性泛发性发疹性脓疱病是由先前的呼吸道感染引发的。一般来说,医学专业人员,特别是儿科医生对这种病理学的了解,将防止采取激进和不适当的方法和管理。