Erythema dyschromicum perstans in a child following an enteroviral meningitis

Abstract

A healthy 6-year-old boy presented with an erythematous macular exanthema, meningeal signs and fever, initially diagnosed with probable bacterial meningitis and treated with antibiotic and anti-inflammatory drugs. Enteroviral meningitis was confirmed, but the skin lesions continued to evolve and the patient was ultimately diagnosed with erythema dyschromicum perstans. The boy was followed during three years until the spontaneous resolution of the dermatosis.

A global consensus statement on ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, idiopathic eruptive macular pigmentation, and Riehl's melanosis

“…This was questioned by Chandran and Kumarasinghe who argued that these cases should be labeled as drug‐induced hyperpigmentation rather than ashy dermatoses . EDP has also been associated with enteroviral, hepatitis C infections and HIV seroconversion . There were reports associating EDP/AD with intake of ethambutol, chlorothalonil, cobalt allergy, ammonium nitrate, Chinese herbal extracts, fluoxetine, etc .…”

Pediatric ashy dermatosis: what to expect?

“…Although there were some reports of AD following drugs and infections, the etiology mostly remains unknown 2,3,7,8 . In our patients, no clear trigger was identified except for the almost simultaneous onset of celiac disease on the second patient.…”

Erythema dyschromicum perstans following neurotoxin injection for facial rhytides

“…In the 1970s, Pinkus proposed that EDP was caused by unidentified environmental antigens that were either inhaled, ingested, or came into contact with the patient’s skin. 1 There are reports of EDP occurring after ingestion of ammonium nitrate, 2 following viral meningitis, 3 and occurring months to years after initiation of proton pump inhibitors. 4 Recently, morphea-like lesions have been reported following BoNT-A injections for facial rhytides.…”