[Recurrent toxin-mediated perineal erythema in an 11-year-old child].
BACKGROUND
Recurrent perineal erythema is a rare toxin-mediated disease. We report the case of recurrent toxin-mediated perineal erythema in a child.


METHODS
An 11-year-old boy was hospitalized for erythematous pustular eruption involving the perineum and the axillary area. This erythema started a few days after the onset of pharyngotonsillitis and the patient's personal history involved another episode of pharyngotonsillitis which was followed by an identical cutaneous eruption. Laboratory analysis confirmed the diagnosis of recurrent toxin-mediated perineal erythema. The skin disorder quickly improved and antistreptococcal antibiotic treatment was initiated to eradicate bacteria.


CONCLUSIONS
Recurrent toxin-mediated perineal erythema is a cutaneous disease mediated by superantigens which are toxins produced by staphylococci and streptococci. It is characterized by recurrent macular erythema involving the perineum. Streptococcus pyogenes is the most common cause of recurrent toxin-mediated perineal erythema, with Staphylococcus aureus being isolated most rarely. This observation emphasizes the possibility of atypical clinical presentation with pustular lesions, and dermatologists must be mindful of this aetiology in order to isolate bacterial toxins and to initiate appropriate antibiotics.
Service de dermatologie, hôpital Beauregard, CHR de Metz-Thionville, 21, rue des Frères, 57100 Thionville, France. amelie.schoeffler@free.fr
A
A
Schoeffler
M
M
Bollaert
P
P
Muller
J
J
Pouaha
F
F
Werts
F
F
Truchetet
D000907:Antibodies, Bacterial / Q000097:blood*; D000989:Antistreptolysin / Q000097:blood*; D002648:Child; D003850:Deoxyribonuclease I / Q000276:immunology*; D003937:Diagnosis, Differential; D004890:Erythema / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D008297:Male; D010502:Perineum; D012008:Recurrence; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis* / Q000276:immunology; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000276:immunology
D000907:Antibodies, Bacterial; D000989:Antistreptolysin; D003850:Deoxyribonuclease I