Perianal Streptococcal Dermatitis in Father and Daughter

Perianal infectious dermatitis: An underdiagnosed, unremitting and stubborn condition

“…However, the main reason for this unknown incidence is considered the fact that PID remains too often unrecognized by healthcare professionals. PID appears all over the world and has been reported by authors in various countries from different continents, including the United States[2,4,5,23,25,26,28,32,38,43,46,57,59,61-63], Canada[3,20,40], Australia[11,33], Africa (Egypt[15]), Europe (United Kingdom[7,10,29,30,65], Spain[6,19,21,31,42,64], Italy[22,35,39,47,48], The Netherlands[36,60], Finland[37], Sweden[41,50], Germany[8,9,45], Denmark[27], Switzerland[12,17,54], France[13,16,55], Greece[58]), Asia (India[44], Taiwan[49], Japan[51,52], Iran[56]), Israel[14,18] and Turkey[53]. It appears that no cases have been published from Eastern Europe.…”

“…Regarding age, PID is particularly encountered in children, especially between the ages of 6 mo and 10 years[2-4,8,11,20,22,28], with a maximum incidence peak between 3 years and 6 years[24]. However, cases have been described in infants less than 6 mo of age[15,23,26,43,57] or older than 10 years[5,10,15,23,26,27,39,48,62], and even in adults[52,61,71-78,81-84].…”

“…Also, most case reports have presented male patients (Table 3). No precise reason has been found for this predominance; hormones and immune factors may contribute to it[52]. However, other series showed smaller rates of male predominance (53%[23], 55.5%[14], 58%[25], 59%[11], 60%[19] and 64%[16]), while four studies reported a slight female predominance (54%[17], 57%[5,26] and 63%[6]).…”

“…Cases of PID in the same family and/or with interfamilial spread have been extensively documented, transmitted from children to parents[52] or vice versa [22,38,50] or between siblings[14,33,35,36,43,47,50,58,59] or other family members[26] or friends[43]. In the study by Kokx et al[4], among 31 children from 19 families, intrafamilial spread was detected only in siblings and occurred in 50% of the possible situations, with 7 families representing multiple cases of PID.…”

“…Although most patients included in this review were seen primarily by their pediatrician or family physician, only three papers were published by physicians from primary healthcare facilities[5,7,50]. Most published reports diagnosing PID have come from dermatologists, working in dermatology university centers[3,15,20,22,31,34,35,40,42,45,52,56,63,79] or hospitals[29,32,47,55], as well as from those in pediatric dermatology university centers[49,53,54,60-62] or hospitals[13,19,26,30]. Also, many of the patients were diagnosed by physicians from pediatric university centers[6,17,18,21,23,25,27,44,57] or hospitals[4,10,16,33,36,39,64,65].…”