Acute febrile neutrophilic dermatosis in children. Report of two cases in male infants.

Two male infants manifested a complex of symptoms and signs that we believed represented a distinctive hypersensitivity disease, with features of acute febrile neutrophilic dermatosis and allergic vasculitis. Both were less than 1 year of age, and both acquired their disease during or after an upper respiratory illness. Each infant was initially seen with waxy and erythematous to slightly violaceous papules that enlarged to form plaques. The lesions developed at sites of trauma and were distributed on the trunk, face, and extremities. Both infants were febrile and had leukocytosis. On histopathologic examination, biopsy specimens taken from the lesions demonstrated a pronounced dermal infiltration of polymorphonuclear leukocytes. These lesions responded to treatment with prednisone and topical fluorinated corticosteroids, healed with scarring, and recurred after initial improvement.