Asymmetric Periflexural Exanthem of Childhood Medication
- Author: Patricia T Ting, MD, MSc, FRCPC, LMCC(Canada); Chief Editor: Dirk M Elston, MD more...
The management of asymmetric periflexural exanthem of childhood typically does not require the use of prescription medications. Low-potency topical steroids such as hydrocortisone 0.5-1% may be used to control inflammation although it usually offers marginal benefit. Hydroxyzine may also be used if the lesions are pruritic and appear disruptive to daily functioning and interfere with normal sleep patterns.
H1-receptor antagonist antihistamines
These agents prevent the histamine response in sensory nerve endings and blood vessels but are not effective at reversing it. They competitively inhibit the binding of histamine at the H1 receptor. Histamine is responsible for mediating wheal and flare reactions, smooth muscle contraction, bronchial constriction, mucus secretion, edema, CNS depression, hypotension, and cardiac arrhythmias.
Hydroxyzine hydrochloride antagonizes H1 receptors in the periphery. It may also suppress histamine activity in subcortical region of the CNS.
Topical anti-inflammatory agents
These agents provide relief of inflammatory eczematous lesions.
Hydrocortisone is a low-potency topical corticosteroid with anti-inflammatory activity, as well as mineralocorticoid and glucocorticoid properties. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing increased capillary permeability. Use 1% cream.
Brunner MJ, Rubin L, Dunlap F. A new papular erythema of childhood. Arch Dermatol. 1962 Apr. 85:539-40. [Medline].
Bodemer C, de Prost Y. Unilateral laterothoracic exanthem in children: a new disease?. J Am Acad Dermatol. 1992 Nov. 27(5 Pt 1):693-6. [Medline].
Taieb A, Megraud F, Legrain V, Mortureux P, Maleville J. Asymmetric periflexural exanthem of childhood. J Am Acad Dermatol. 1993 Sep. 29(3):391-3. [Medline].
Arun B, Salim A. Transient linear eruption: asymmetric periflexural exanthem or blaschkitis. Pediatr Dermatol. 2010 May-Jun. 27(3):301-2. [Medline].
Bauza A, Redondo P, Fernandez J. Asymmetric periflexural exanthem in adults. Br J Dermatol. 2000 Jul. 143(1):224-6. [Medline].
Chan PK, To KF, Zawar V, Lee A, Chuh AA. Asymmetric periflexural exanthem in an adult. Clin Exp Dermatol. 2004 May. 29(3):320-1. [Medline].
Corazza M, Virgili A. Asymmetric periflexural exanthem in an adult. Acta Derm Venereol. 1997 Jan. 77(1):79-80. [Medline].
Auvin S, Imiela A, Cuvellier JC, Catteau B, Vallee L, Martinot A. Asymmetric periflexural exanthem of childhood in a child with axonal Guillain-Barre syndrome. Br J Dermatol. 2004 Feb. 150(2):396-7. [Medline].
Guimera-Martin-Neda F, Fagundo E, Rodriguez F, et al. Asymmetric periflexural exanthem of childhood: report of two cases with parvovirus B19. J Eur Acad Dermatol Venereol. 2006 Apr. 20(4):461-2. [Medline].
Harangi F, Varszegi D, Szucs G. Asymmetric periflexural exanthem of childhood and viral examinations. Pediatr Dermatol. 1995 Jun. 12(2):112-5. [Medline].
Pauluzzi P, Festini G, Gelmetti C. Asymmetric periflexural exanthem of childhood in an adult patient with parvovirus B19. J Eur Acad Dermatol Venereol. 2001 Jul. 15(4):372-4. [Medline].