Infantile acropustulosis

Abstract

Infantile acropustulosis is a syndrome that is characterized by recurrent crops of 1- to 2-mm, intensely pruritic vesicopustules on the distal extremities. The eruption is unresponsive to topical steroids, and pruritus is relieved only by soporific doses of antihistamines.

Infantile Acropustulosis

“…In contrast with previously published cases [4][5][6], pustular content showed many eosinophils together with neutrophils. A possible explanation is that this is a typical case of IA occurring by chance in a baby with modest persistent eosinophilia and, since generally eosinophils migrate into exudates with an eosinophil/neutrophil ratio approximately similar to the ratio in blood, a mere contamination could be responsible for the occasional presence of eosinophils in the pustular content.…”

“…A possible explanation is that this is a typical case of IA occurring by chance in a baby with modest persistent eosinophilia and, since generally eosinophils migrate into exudates with an eosinophil/neutrophil ratio approximately similar to the ratio in blood, a mere contamination could be responsible for the occasional presence of eosinophils in the pustular content. Nevertheless, eosinophils are frequently found in infantile pustular erup tions; let us think, for example, of incontinentia pigmenti; and, as stressed by Jarratt andRam sdell [4], both erythema toxicum and transient pustular melanosis have eosinophils in their pustules. In our case, no cause for the persistent eosinophilia could be found and no other pathological condition except for IA was present.…”

“…Infantile acropustulosis (1A) was recognized as a new entity in 1979 by Kahn and Rywlin [5] and Jarran and Ramsdeil [4], It is characterized by recurrent crops of pruritic pustules located on the hands, feet and head; the affection occurs in newborns or babies and spontaneously resolves after an evolution of a few years; it is unaffected by any treatment except for dapsone (DDS) which shows a morbistatic action. Histologically, there are subcorneal pustules filled with polymorphonuclear leukocytes.…”

“…Histologically, there are subcorneal pustules filled with polymorphonuclear leukocytes. According to these authors [4,5], this condition is not rare, especially among black infants, nevertheless there have been only a few subsequent reports on it [3,6]. Infantile vesicopustular eruptions are not uncommon and new enti ties have been identified (erythema toxicum [1], transient neonatal pustular melanosis [7], eosinophilic papulovesicular dermatitis of infancy [2], but they are clinically and histologically easily differentiated from IA.…”

Pyodermitis of Genital Areas: An Atypical Manifestation of Eosinophilic Pustulosis of Childhood

“…Infantile acropustulosis [2] is characterized by recurrent episodes of pruriginous pustules affecting the extremities (hands and feet), with a spontaneously favourable course over several months or years. Topical corticosteroids or dapsone are useful in severe forms associated with frequent or severe episodes [3]. Histological examination of the early lesions of acropustulosis [4] shows epidermal spongiosis, which subsequently leads to the formation of intra-epidermal vesicles and pustules, successively colonized by an infiltrate predominantly composed of neutrophils rather than eosinophils (fig.…”