What is Asymmetric Periflexural Exanthem in Childhood?
Asymmetric periflexural exanthem of childhood (APEC) is a skin condition first identified in 1962 as “a new papular erythema”, a term which means a new type of rash with small, raised spots. The name APEC was proposed in 1993. This skin issue typically affects children but can also occur in adults, and it usually goes away on its own after some time.
Doctors aren’t exactly sure what causes APEC, but they think a virus might be behind it. However, this theory has not been confirmed. The condition appears as a rash with small raised spots on one side of the body. It’s unique in how it looks and where it appears on the body.
Generally, there’s no need for specific tests or skin samples (biopsies) to diagnose this condition because it has a great prognosis, meaning it typically resolves on its own within a few weeks.
What Causes Asymmetric Periflexural Exanthem in Childhood?
This skin condition’s exact cause is still unknown, even though researchers are actively looking for it. However, several signs point to the possibility of a virus being the cause. These signs include having multiple children in the same family with the condition, certain lab test findings, similar symptoms experienced with common colds or digestive issues, the lack of effectiveness of antibiotics, and more instances of the disease occurring in springtime.
Studies have considered that the disease might be linked to infections with different types of viruses, such as parainfluenza, adenovirus, human herpesvirus, and Epstein-Barr virus. There are even cases where a certain skin rash in childhood occurred after a respiratory tract infection and led to a nervous system condition known as axonal Guillain-Barré syndrome. Parvovirus B19 has been reported in two female children and one adult patient with this skin condition.
Nevertheless, there are other potential causes under contemplation by various experts. These include insect bites, bacterial infections, and contact dermatitis, a skin condition caused by touching a substance that irritates the skin or causes an allergic reaction. However, these hypotheses have not yet been confirmed. Importantly, there’s no evidence that the disease can be spread from person to person.
Risk Factors and Frequency for Asymmetric Periflexural Exanthem in Childhood
Asymmetric periflexural exanthem of childhood, also known as APEC, is a condition that’s been reported in 300 cases in Europe, the United States, and Canada. It seems to be more common in France and Italy. It can happen any time of the year but is most frequent in winter and spring, which suggests that it may be caused by a virus.
- APEC mainly affects individuals from light-skinned ethnic groups. The reason for this is yet to be understood, and further study is needed.
- APEC is more common in females than it is in males. The ratio is estimated to be 2 females for every 1 male.
- The condition is most commonly seen in children between the ages of 2 and 3 years. However, it can also affect adults, but this is less common.
Signs and Symptoms of Asymmetric Periflexural Exanthem in Childhood
When you first develop the rash associated with this condition, you usually see it on one side of your body and it looks like a mixed red and raised spotted rash. This typically starts in an armpit but can also begin in other folds of your skin like those on your thigh, side, or groin. After about 10 to 15 days, the rash might spread to the chest area, the arm on the same side, and sometimes to the opposite side of the body. However, even when the rash spreads, it usually stays more pronounced on one side.
Sometimes, the rash may look like it’s forming a winding pattern and have a central area that’s bluish-gray. As it starts healing, the rash could look darker and eventually peel. The rash typically does not affect the face, palms, soles of your feet, or inside your body around the mouth or in other areas. Your skin doesn’t usually thicken with this condition. About half of the people who encounter this could feel itchy on the rash and might have mildly swollen local lymph nodes.
On rare occasions, other symptoms like fever, sore throat, vomiting, and diarrhea can happen when the rash first appears. However, this doesn’t generally affect your overall health and all symptoms usually go away between 4 and 6 weeks without coming back or leaving scars.
Testing for Asymmetric Periflexural Exanthem in Childhood
Asymmetric periflexural exanthem of childhood, or APEC, is diagnosed based on symptoms seen in the patient. There’s no need for lab tests or examining for viruses to confirm this condition. Sometimes, APEC may be accompanied by a higher than normal rate at which red blood cells settle at the bottom of a tube (something known as the erythrocyte sedimentation rate). Lastly, doctors don’t recommend regular biological or imaging tests to monitor this condition.
Treatment Options for Asymmetric Periflexural Exanthem in Childhood
Asymmetric periflexural exanthem of childhood, a skin condition, doesn’t usually require any particular medical treatment. Sometimes, doctors might prescribe mild to moderate strength skin creams or lotions that contain steroids to help control inflammation. However, this method tends not to have a big impact.
If the condition is causing itchiness, oral antihistamines (allergy medicines) and moisturizers might be used. These offer a different route to help manage the symptoms.
What else can Asymmetric Periflexural Exanthem in Childhood be?
Asymmetric periflexural exanthem of childhood (APEC) is a skin condition in kids that may be confused with several others due to its unique appearance. These skin conditions include:
- Contact dermatitis: It can affect one side of the body, but it is usually itchy.
- Non-specific viral rashes: These could look like the rash caused by APEC.
- Drug-related rashes: These are skin eruptions due to an adverse reaction to a drug.
- Miliaria: Also known as “heat rash”, this usually shows up symmetrically on the neck and upper body.
- Atypical pityriasis rosea: This is common in school children and young adults, and may resemble APEC in terms of when it appears, how long it lasts, and that it tends to go away on its own.
- Gianotti-Crosti syndrome: This skin condition also affects the same age group and shows up with a rash. However, the rash in this condition is symmetrical and often comes with swollen lymph nodes and enlargement of the liver and spleen.
- Superficial fungal infections, scabies, and scarlet fever: These can also look like APEC.
A proper diagnosis can differentiate between APEC and these similar conditions, enabling appropriate treatment.
What to expect with Asymmetric Periflexural Exanthem in Childhood
The outlook for asymmetric periflexural exanthem of childhood, a type of skin rash, is very good. This condition typically clears up on its own in about 4 to 6 weeks without needing specific medical treatment. Even though this skin issue is harmless, the rash can still cause a lot of worry for both the patient and their caregivers.
Possible Complications When Diagnosed with Asymmetric Periflexural Exanthem in Childhood
No past reports have mentioned any recurring problems or overall body complications.
Preventing Asymmetric Periflexural Exanthem in Childhood
Parents should be informed and reassured that the skin condition known as asymmetric periflexural exanthem of childhood is harmless and temporary, typically clearing up in a few weeks. Since this skin condition usually doesn’t cause any discomfort or have any negative impact on the child’s overall health, there are no specific tests or treatments required.
