Perineal Eruption in Kawasaki's Syndrome

To the Editor.—  Kawasaki's syndrome (mucocutaneous lymph node syndrome) is an acute idiopathic exanthem and enanthema, principally affecting children under 5 years of age. The six principal diagnostic criteria include persistent fever, cervical adenopathy, conjunctival injection, oral lesions (erythema of the lips and oropharynx as well as strawberry tongue), acral involvement (erythema of the palms and soles, edema of the hands and feet, followed by desquamation of the digital tips), and a polymorphous exanthem.¹ In decreasing order of frequency, the exanthem may be urticarial with erythematous plaques, which are sometimes targetoid, morbilliform, macular and papular, and scarletiniform.¹Although the exanthem is usually truncal, in two of our patients, it was primarily localized in the diaper area and, furthermore, was one of the earliest physical signs. This specific distribution has been described by Fink² and Aballi³ in the pediatric medical literature. Awareness of this perineal eruption by