Aged ; Diagnosis, Differential ; Exanthema/etiology* ; Female ; Humans

Adult ; Diagnosis, Differential ; Exanthema ; etiology ; Histiocytic Necrotizing Lymphadenitis ; complications ; diagnosis ; Humans ; Lymphatic Diseases ; etiology ; Male

A girl, aged 22 months, attended the hospital due to recurrent vulvar rashes for more than half a year. Skin biopsy showed Langerhans cell histiocytosis, and evaluation of systemic conditions showed no systemic involvement. Therefore, the girl was diagnosed with Langerhans cell histiocytosis (skin type). In conclusion, for rashes on the vulva alone, if there are no specific clinical manifestations, the possibility of Langerhans cell histiocytosis should be considered after molluscum contagiosum, sexually transmitted diseases, and Fordyce disease are excluded.
Developmental Disabilities ; Exanthema/etiology* ; Female ; Histiocytosis, Langerhans-Cell ; Humans ; Infant ; Vulvar Diseases/diagnosis*

Adult ; Exanthema ; diagnosis ; drug therapy ; etiology ; physiopathology ; Humans ; Male ; Pruritus ; physiopathology ; Steroids ; administration & dosage ; Treatment Outcome

OBJECTIVETo describe the etiology, clinical features and treatment of childhood acute generalized exanthematous pustulosis (AGEP).

METHODSClinical data from 20 cases of childhood acute generalized exanthematous pustulosis from 1990 to 2008 were retrospectively reviewed.

RESULTSEighteen cases had a history of medication, including the use of penicillin (n=6), cephalosporins (n=3), sulphonamides (n=2), algopyrin (n=2), vaccines (n=2 ) and anti-cold drugs (n=3). Fever and generalized erythematous pustules were observed in all 20 cases. Histopathologic examination revealed spongiform superficial pustules and papillary edema. The patients were asked to stop taking suspected sensitizing drugs and received glucocorticoid treatment (1-2 mg/kg daily). After 3-5 days of the treatment, symptoms were improved and the dosage of glucocorticoid was gradually reduced. All patients were healed within 20 days after treatment.

CONCLUSIONSThe cause of AGEP is mainly attributed to the use of antibiotics, sulphonamides, antipyretic analgesics and vaccines in children. AGEP is characterized by fever and widespread pustular eruption of the skin. Removal of sensitizing factors and glucocorticoid administration is important in the treatment of AGEP in children.

Child ; Child, Preschool ; Drug Eruptions ; diagnosis ; etiology ; therapy ; Exanthema ; diagnosis ; etiology ; therapy ; Female ; Humans ; Male ; Prognosis ; Retrospective Studies ; Skin Diseases, Vesiculobullous ; diagnosis ; etiology ; therapy

Aged, 80 and over ; Exanthema ; etiology ; Female ; Humans ; Leukemia, Monocytic, Acute ; pathology ; Leukemic Infiltration ; complications ; diagnosis ; Skin ; pathology

OBJECTIVETo study the incidence of cases with rash and fever illness (RFIs) after measles vaccine (MV) inoculation.

METHODSDuring 1999 to 2002, 150 RFIs cases reported by the special measles surveillance system in Shandong province, China, were investigated and analyzed epidemiologically.

RESULTS7 674 690 ml MV were distributed during 1999 to 2002 and the annual average incidence of RFIs cases after MV inoculation was 0.20/10 000 ml (0.2 ml per dose). There was significant difference of incidences each year (chi(2) = 10.13, P < 0.05). All RFIs cases were sporadically distributed without epidemiological links. Clinical symptoms showed that 88.67% of the 150 RFIs cases having > 38.5 degrees C fever and 75.33% of all cases appeared typical rash after 4 to 11 days (the medium was 8 days) after MV inoculation. The order of rash onset among RFIs cases was consistent with that of regular measles cases caused by wild virus. 68.67% of the RFIs cases had first MV inoculation and 94.71% were 8 to 12 month-olds. IgM sera antibody test from RFIs cases were rubella negative and 45.65% positive for measles.

CONCLUSIONRFIs due to allergic reaction or measles vaccine virus infection might occur after MV inoculation. There seemed to be a correlation between RFIs incidence and the doses of MV. Measles virus genotype analysis needs to be carried out to confirm if the onset of some RFIs cases is aetiologically associated to MV vaccine virus infection.

Exanthema ; etiology ; virology ; Fever ; etiology ; virology ; Humans ; Measles ; prevention & control ; Measles Vaccine ; adverse effects ; Measles virus ; immunology ; Polymerase Chain Reaction ; Vaccination

The clinical findings of fever and skin rash with or without evidence of fluid retention, which mimic engraftment syndrome, have been observed during the pre-engraftment period in patients undergoing hematopoietic stem cell transplantation. In order to characterize this newly observed clinical syndrome called pre-engraftment syndrome (pES), we retrospectively analyzed the clinical records of 50 patients. Three out of 14 patients (23.1%) who underwent cord blood stem cell transplantation developed non-infectious fever, skin rash, and tachypnea 4-15 days prior to neutrophil engraftment. Two patients spontaneously recovered with fluid restriction and oxygen inhalation. One patient died of a complicated pulmonary hemorrhage in spite of aggressive supportive therapy and steroid treatment. Four out of 23 patients (17.4%) who underwent allogeneic bone marrow transplantation developed non-infectious fever and skin rash 4 to 5 days prior to neutrophil engraftment. All four of these patients recovered with only steroid treatment. These characteristic findings were not observed in patients who had undergone autologous peripheral blood stem cell transplantation. Interestingly, the speed of neutrophil engraftment was significantly faster for the patients suffering from pre-engraftment syndrome. The close observation and further pathophysiological research are required to better understand this syndrome.
Adolescent ; Child ; Child, Preschool ; Exanthema/epidemiology/*etiology ; Female ; Fever/epidemiology/*etiology ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Humans ; Incidence ; Infant ; Male ; Retrospective Studies ; Risk Factors ; Syndrome

OBJECTIVETo study the Chinese medicine (CM) syndrome laws of patients with pruritic papular eruption (PPE), thus providing reference for its classification and standard diagnosis.

METHODSUsing multicenter, prospective trials in 346 PPE patients,the correlations between sex, age, infection route, and CD4 levels and CM syndrome patterns were analyzed. The syndrome laws correlated with PPE was studied from the macroscopic and microscopic aspects.

RESULTSThere was no statistical difference in sex, age, or CD4 level among various CM syndrome patterns. There was statistical difference in the infection route among various CM syndrome patterns. Pi-deficiency dampness-accumulation syndrome occurred more in patients infected by blood. Wind production induced by heat in blood syndrome occurred more in those infected by sexual contact. Blood deficiency wind dryness syndrome occurred in those infected by intravenous drug abuse.

CONCLUSIONSWind production induced by heat in blood syndrome, blood deficiency wind dryness syndrome, and Pi-deficiency dampness-accumulation syndrome exist in CM syndrome types of AIDS. There was statistical difference in different infection routes of the distribution of each syndrome type.

Acquired Immunodeficiency Syndrome ; complications ; diagnosis ; Adolescent ; Adult ; Exanthema ; diagnosis ; etiology ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Prospective Studies ; Pruritus ; diagnosis ; etiology ; Young Adult

OBJECTIVETo improve the recognition of the clinical presentation and radiologic manifestation of children with Langerhans cell histiocytosis (LCH) with pulmonary involvement.

METHODA retrospective analysis was conducted on children who presented with respiratory symptoms or abnormal lung radiologic findings, and finally diagnosed with LCH in Ward 2 of Divison of Respiratory Diseases, Beijing Children's Hospital during the last 4 years.

RESULTFourteen children (10 boys and 4 girls) were included in this study. Male to female ratio was 2.5: 1. The median age was 1.3 years. Pulmonary involvements were coexisted with other involved organs in all the patients, such as skin (10 cases, 71%), liver (8 cases, 57%), and bone involvement (7 cases, 50%). The most common symptoms were cough and fever (7 cases, 50%). Respiratory symptoms were nonspecific, and 3 children had no respiratory symptom but abnormal findings on lung high-resolution CT (HRCT). The most common HRCT finding was the coexistence of nodules and cysts (6 cases, 43%). Other findings include cysts only (5 cases, 36%), nodules only (1 case), and with neither nodule nor cyst (2 cases, 14%). Pneumothorax was found in 7% of children.

CONCLUSIONPulmonary involvement in children with LCH is easily misdiagnosed, and often coexisted with other involved tissues/organs such as skin and liver. Rash, which is easily missed in physical examination is very important for the diagnosis of LCH. The characteristic findings of lung HRCT (nodules and/or cysts) are helpful for diagnosis.

Child ; Cough ; etiology ; Cysts ; Diagnostic Errors ; Exanthema ; etiology ; Female ; Fever ; etiology ; Histiocytosis, Langerhans-Cell ; complications ; diagnostic imaging ; Humans ; Infant ; Liver ; Lung Diseases ; diagnostic imaging ; Male ; Retrospective Studies ; Skin ; Tomography, X-Ray Computed