Asymmetric periflexural exanthem of childhood

Asymmetric Periflexural Exanthem of Childhood

Asymmetric Periflexural Exanthem of Childhood (APEC), also known as Unilateral Laterothoracic Exanthem, is a self-limiting skin condition predominantly affecting children. It is characterized by a unilateral rash that typically appears in the flexural areas of the body, such as the armpits and groin.

Clinical Presentation

APEC usually presents in children between the ages of 1 and 5 years. The condition is marked by the sudden onset of a rash that is often confined to one side of the body. The rash is erythematous and papular, and it may spread to involve other areas, but it remains predominantly unilateral.

The rash is often accompanied by mild systemic symptoms such as low-grade fever, malaise, and occasionally lymphadenopathy. The exanthem typically resolves spontaneously within 4 to 6 weeks without any specific treatment.

Etiology

The exact cause of APEC is unknown, but it is believed to be a viral exanthem. Several viral agents have been proposed, including Epstein-Barr virus, parvovirus B19, and adenovirus, but no definitive causative agent has been identified.

Diagnosis

Diagnosis of APEC is primarily clinical, based on the characteristic appearance and distribution of the rash. Laboratory tests are generally not required unless there is a need to rule out other conditions. Differential diagnosis includes other viral exanthems, guttate psoriasis, and contact dermatitis.

Management

Management of APEC is supportive. Since the condition is self-limiting, reassurance and symptomatic treatment are usually sufficient. Antihistamines may be used to alleviate itching, and emollients can help soothe the skin.

Prognosis

The prognosis for APEC is excellent, with complete resolution of the rash typically occurring within a few weeks. There are no known long-term complications associated with the condition.

Also see

• Viral exanthem
• Guttate psoriasis
• Contact dermatitis
• Pityriasis rosea