Infantile Acropustulosis

Bundino, S.; Zina, A.M.; Ubertalli, S.

doi:10.1159/000250030

Cited by 21 publications

(5 citation statements)

References 4 publications

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“…The content of the intraepidermal vesicle consists of neutrophils and, sometimes, eosinophils. The presence of eosinophils, either in the blood or in the vesicle, does not indicate a different course for the disease (4,9), but is rather characteristic of younger patients (4). Direct immunofiuorescence was negative and did not aid either in understanding IA or in making its diagnosis (9).…”

Section: Commentsmentioning

confidence: 86%

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Infantile Acropustulosis

Dromy

Raz

Metzker

1991

Pediatric Dermatology

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Infantile acropustulosis is a recurrent, pruritic, vesicopustular eruption appearing mostly on the palms and soles. The present survey of 25 children with infantile acropustulosis is the most extensive reported since this entity was first described in 1979. Our cases conform to the recognized clinical course, but disclaim any male or ethnic origin predominance. Although the etiology of infantile acropustulosis is obscure, it may be ascribed to some infective agent. It is not limited to young children, and has been found in the siblings of patients who were followed. Suppressive therapeutic measures, such as topical corticosteroids under occlusion, were found to be effective. The disorder does not seem to be as rare as one might gather from the literature.

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Section: Commentsmentioning

confidence: 86%

“…This ethnic predilection derives possibly from the population demographics in the communities where the surveys originated. Further descriptions included Caucasian infants from Italy, France, and Norway (3,9,10). Our survey concerns children of yet other ethnic origins, Jewish and Arabic.…”

Section: Commentsmentioning

confidence: 99%

Infantile Acropustulosis

Dromy

Raz

Metzker

1991

Pediatric Dermatology

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“…In the literature there is a huge number of case reports, clinical studies and epidemiological analyses representing beneficial effects of dapsone in such dermatological entities, collectively termed as sulfone-sensitives dermatoses. Despite a large body of evidence the subsequent enumeration is indicating only a small number of relevant references [21, 30, 31, 56, 62, 65, 68, 74, 82–84, 98, 126, 133, 143, 153, 164, 175, 179]. Finally, there are some conditions in which dapsone was reported anecdotically as being useful, but initial enthusiasm has been tempered with subsequent controversial or contradictory results and/or a total lack of properly controlled trials showing efficacy.…”

Section: Clinical Use Of Dapsonementioning

confidence: 99%

Dapsone in dermatology and beyond

2013

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Dapsone (4,4′-diaminodiphenylsulfone) is an aniline derivative belonging to the group of synthetic sulfones. In 1937 against the background of sulfonamide era the microbial activity of dapsone has been discovered. Shortly thereafter, the use of dapsone to treat non-pathogen-caused diseases revealed alternate antiinflammatory mechanisms that initially were elucidated by inflammatory animal models. Thus, dapsone clearly has dual functions of both: antimicrobial/antiprotozoal effects and anti-inflammatory features similarly to non-steroidal anti-inflammatory drugs. The latter capabilities primarily were used in treating chronic inflammatory disorders. Dapsone has been investigated predominantly by in vitro methods aiming to get more insights into the effect of dapsone to inflammatory effector cells, cytokines, and/or mediators, such as cellular toxic oxygen metabolism, myoloperoxidase-/halogenid system, adhesion molecules, chemotaxis, membrane-associated phospholipids, prostaglandins, leukotrienes, interleukin-8, tumor necrosis factor α, lymphocyte functions, and tumor growth. Moreover, attention has been paid to mechanisms by which dapsone mediates effects in more complex settings like impact of lifespan, stroke, glioblastoma, or as anticonvulsive agent. Additionally, there are some dermatological investigations in human being using dapsone and its metabolites (e.g., leukotriene B4-induced chemotaxis, ultraviolet-induced erythema). It could be established that dapsone metabolites by their own have anti-inflammatory properties. Pharmacology and mechanisms of action are determining factors for clinical use of dapsone chiefly in neutrophilic and/or eosinophilic dermatoses and in chronic disorders outside the field of dermatology. The steroid-sparing effect of dapsone is useful for numerous clinical entities. Future avenues of investigations will provide more information on this fascinating and essential agent.

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“…Laboratory' studies are usually normal, but peripheral blood eosinophilia has been reported (11). A Tzanck smear (Giemsa, Wright, or Hemacolor® stain) or Gram's stain of pustular content reveals numerous neutrophils, occasionally eosinophils, and no bacteria (11,12). On histopathologic examination well-circumscribed, subcomeal pustules with polymorphic neutrophils and occasional eosinophils are seen.…”

Section: Infantile Acropustulosismentioning

confidence: 99%

Diagnosis and Treatment of Pustular Disorders in the Neonate

Praag

Rooij

Folkers

et al. 1997

Pediatric Dermatology

106

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The diagnosis of a pustular dermatosis occurring during the first months of life is usually based on clinical findings. However, some cases may require simple investigations including microscopic examination of pustular content, cultures, and skin biopsies. The main benign transient neonatal types of pustulosis include erythema toxicum neonatorum, infantile acropustulosis, transient neonatal pustular melanosis, and neonatal acne. The most common causes of infectious pustular skin lesions include bacterial infections, which may be initially localized (Staphylococcus aureus) or septicemic (with Listeria monocytogenes as the leading causitive agent); viral infections (herpes simplex, varicella-zoster, and cytomegalovirus infections); fungal infections (candidiasis); or parasitic disorders (scabies). The main objective of this article is to propose a systematic approach to pustular eruptions in the neonate. The need for investigating every neonate with pustules for an infectious disease is emphasized. The Tzanck smear, the Gram's stain, and a potassium hydroxide preparation are the most important quick diagnostic tests. The Tzanck smear is a very easy, rapid, and sensitive test for detection of a herpetic infection (multinucleated giant cells) as well as noninfectious pustular eruptions (eosinophils, neutrophils). Therefore the Tzanck smear should be the first test performed. Moreover, a Gram's stain and potassium hydroxide preparation should be performed in cases of neonatal pustular disorders to detect bacterial and fungal infections. The goal of this diagnostic approach is to spare a healthy neonate with a benign transient condition an invasive evaluation for sepsis, potentially harmful antibiotic therapy, and prolonged hospitalization, with its own inherent morbidity.

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Infantile Acropustulosis

Cited by 21 publications

References 4 publications

Infantile Acropustulosis

Infantile Acropustulosis

Dapsone in dermatology and beyond

Diagnosis and Treatment of Pustular Disorders in the Neonate

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