Acropustulosis of Infancy Medication

Updated: Apr 15, 2019
  • Author: Cassondra A Ellison, MD; Chief Editor: Dirk M Elston, MD  more...
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Medication

Medication Summary

High-potency topical steroids (classes 1 and 2) have been used successfully for control of pruritus. Oral sedating antihistamines may reduce pruritus and aid in sleep for irritable and extremely uncomfortable children. Children who are extremely symptomatic may be treated with dapsone as it has been noted to relieve symptoms within 24 hours and signs within 72 hours in some cases. [15] Oral antibiotics and oral glucocorticoids have been used in isolated cases, but are rarely necessary. [10]

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Topical steroids

Class Summary

These agents provide symptomatic relief of pruritus.

Betamethasone topical (Diprolene, Betatrex)

Topical betamethasone is used for inflammatory dermatoses responsive to steroids. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing capillary permeability. Use fluorinated topical steroids with caution in children.

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Antihistamines, 1st Generation

Class Summary

Sedating antihistamines may provide symptomatic relief of pruritus.

Diphenhydramine (Alka-Seltzer Plus Allergy, Benadryl, Benadryl Allergy Dye-Free LiquiGels)

Diphenhydramine is an antihistamine used for pruritus and allergic reactions.

Hydroxyzine (Vistaril)

Hydroxyzine is an antihistamine with antipruritic, anxiolytic, and mild sedative effects. It antagonizes H1 receptors in the periphery, and it may suppress histamine activity in the subcortical region of the CNS. Syrup is available as 10 mg/5 mL.

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Antibiotics

Class Summary

Diaminodiphenylsulfone antibiotics have been used as anti-inflammatory agents.

Dapsone (Avlosulfon)

Dapsone is bactericidal and bacteriostatic against mycobacteria; its mechanism of action is similar to that of sulfonamides, where competitive antagonists of PABA prevent the formation of folic acid, inhibiting bacterial growth. It is used mainly to treat leprosy and dermatitis herpetiformis. Dapsone has antineutrophil and anti-inflammatory properties.

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Antipruritics

Class Summary

These agents may relieve associated itching.

Pramoxine topical (Tronothane, Prax)

Topical pramoxine blocks nerve conduction and impulses by inhibiting depolarization of neurons. Use 1% lotion or cream.

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