Asymmetric periflexural exanthem of childhood - A clinical, pathologic, and epidemiologic prospective study

Objective: To assess the clinical, pathologic, and epidemiologic features o f asymmetric periflexural exanthem of childhood (APEC), a clinically distin ctive eruption, especially its link with pityriasis rosea and pattern of tr ansmission. Design: A prospective case series, including an analysis of epidemiologic t riggering factors and mode of transmission. Pathologic study, including imm unohistochemistry of the inflammatory infiltrate. Setting: A mixed, community-based referral center. Patients: A total of 37 girls and 30 boys with typical APEC referred from A pril 1994 to December 1996 were included in the study; 82% came from the gr eater Bordeaux area in France. Intervention: None. Main Outcome Measure: Possible interhuman transmission of APEC. Results: No triggering factor was identified; no interhuman transmission oc curred; and no demonstrable link with pityriasis rosea was apparent. Severa l new clinical variants were recognized or confirmed (high fever, facial an d peripheral involvement, prolonged course). Distinctive perisudoral interf ace CD8(+) infiltrate was suggestive of diagnosis. Conclusions: Interhuman transmission was doubtful, but inoculation disorder was still possible. Histopathologic findings seem more specific than previ ously thought.