In this issue of the Archives, Patrizi and colleagues1 describe 11 previously healthy children with an often recurrent and very distinctive perineal eruption in the setting of streptococcal infections. One of the children also had Staphylococcus aureus recovered from a skin culture. Some of the children had erythema and ultimate desquamation of the skin on the palms (n = 4) and axillae (n = 1). The authors relate these findings to recurrent toxin-mediated perineal erythema (RTPE) reported by Manders et al2 in this journal in 1996. One of those 2 cases described involved a 16-year-old boy. These patients were found to have positive bacterial cultures for Streptococcus pyogenes (case 1) and S aureus (case 2), and both yielded toxins on further investigation.
Levy ML. Recurrent Toxin-Mediated Perineal Erythema in Children: Is That All There Is? Arch Dermatol. 2008;144(2):245. doi:10.1001/archdermatol.2007.39
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