Asymmetric Periflexural Exanthem of Childhood: Microbiologic Case‐Control Study

Coustou, D.; Masquelier, Bernard; Lafon, Marie‐Edith; Labrèze, Christine; Roul, S.; Bioulac‐Sage, Paulette; Mégraud, Françis; Fleury, H. J. A.; Taı̈eb, Alain

doi:10.1046/j.1525-1470.2000.01745.x

Cited by 29 publications

(15 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HBV is the most common cause of hepatocellular carcinoma, 47 while EBV is significantly associated with Hodgkin's lymphoma, Burkitt's lymphoma, and nasopharyngeal carcinoma. 48 …”

Section: Virological Investigationsmentioning

confidence: 99%

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Chuh

Zawar²,

Law

et al. 2012

Infectious Disease Reports

View full text Add to dashboard Cite

Several exanthems including Gianotti-Crosti syndrome, pityriasis rosea, asymmetrical periflexural exanthem, eruptive pseudoangiomatosis, and papular-purpuric gloves and socks syndrome are suspected to be caused by viruses. These viruses are potentially dangerous. Gianotti-Crosti syndrome is related to hepatitis B virus infection which is the commonest cause of hepatocellular carcinoma, and Epstein-Barr virus infection which is related to nasopharyngeal carcinoma. Pityriasis rosea has been suspected to be related to human herpesvirus 7 and 8 infections, with the significance of the former still largely unknown, and the latter being a known cause of Kaposi's sarcoma. Papular-purpuric gloves and socks syndrome is significantly associated with human B19 erythrovirus infection which can lead to aplastic anemia in individuals with congenital hemoglobinopathies, and when transmitted to pregnant women, can cause spontaneous abortions and congenital anomalies. With viral DNA sequence detection technologies, false positive results are common. We can no longer apply Koch's postulates to establish cause-effect relationships. Biological properties of some viruses including lifelong latent infection, asymptomatic shedding, and endogenous reactivation render virological results on various body tissues difficult to interpret. We might not be able to confirm or refute viral causes for these rashes in the near future. Owing to the relatively small number of patients, virological and epidemiology studies, and treatment trials usually recruit few study and control subjects. This leads to low statistical powers and thus results have little clinical significance. Moreover, studies with few patients are less likely to be accepted by mainstream dermatology journals, leading to publication bias. Aggregation of data by meta-analyses on many studies each with a small number of patients can theoretically elevate the power of the results. Techniques are also in place to compensate for publication bias. However, these are not currently feasible owing to different inclusion and exclusion criteria in clinical studies and treatment trials. The diagnoses of these rashes are based on clinical assessment. Investigations only serve to exclude important differential diagnoses. A wide spectrum of clinical features is seen, and clinical features can vary across different populations. The terminologies used to define these rashes are confusing, and even more so are the atypical forms and variants. Previously reported virological and epidemiological results for these rashes are conflicting in many aspects. The cause of such incongruence is unknown, but low homogeneity during diagnosis and subject recruitment might be one of the factors leading to these incongruent results. The establishment and proper validation of diagnostic criteria will facilitate clinical diagnosis, hasten recruitment into clinical studies, and allow results of different studies to be directly compared with each another. Meta-analyses and systematic reviews would be more valid. Diagn...

show abstract

“…HBV is the most common cause of hepatocellular carcinoma, 47 while EBV is significantly associated with Hodgkin's lymphoma, Burkitt's lymphoma, and nasopharyngeal carcinoma. 48 …”

Section: Virological Investigationsmentioning

confidence: 99%

Gianotti-Crosti Syndrome, Pityriasis Rosea, Asymmetrical Periflexural Exanthem, Unilateral Mediothoracic Exanthem, Eruptive Pseudoangiomatosis and Papular-Purpuric Gloves and Socks Syndrome: A Brief Review and Arguments for Diagnostic Criteria

Chuh

Zawar²,

Law

et al. 2012

Infectious Disease Reports

View full text Add to dashboard Cite

show abstract

“…However, interhuman transmission was not clearly documented (8). In a microbiological case-control study, Coustou et al were not able to point to a specific virus or bacteria (14).…”

Section: Disscusionmentioning

confidence: 97%

Unilateral Laterothoracic Exanthem – Asymmetric Periflexural Exanthem of Childhood – a Case Report and Literature Review

Prćić

Gajinov

Radulović

et al. 2017

Serbian Journal of Dermatology and Venereology

View full text Add to dashboard Cite

Unilateral laterothoracic exanthem (ULE), or asymmetric periflexural exanthem of childhood (APEC), is an uncommon skin eruption that usually occurs in childhood, with unilateral distribution and self limiting course. The etiology of ULE is unknown, but viral cause is suspected. We report a case of ULE in a 4-year-old girl, that was associated with parvo virus B19 infection, and a brief selected literature review. The patient presented with unilateral maculopapular rash on the left side of the body which was asymptomatic and resolved spontaneously within 5 weeks. The clinical diagnosis of ULE may be precise, ruling out a broad spectrum of differential diagnosis, and prevent unnecessary examinations, whereas the patient is informed about the benign self-limiting nature of ULE.

show abstract

“…However, we have no information on the seroprevalence of CMV in Romania. CMV infection is not strongly associated with ULE [5], and there exists no licensed active intervention for congenital CMV infection. We thus hesitate on how far one should proceed in clinical settings independent of academic discussions and speculations.…”

Section: Comments To the Articlementioning

confidence: 99%