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Acropustulosis of infancy

29 September 2015, by WALLACH D. & VIGNON-PENNAMEN M-D.

Acropustulosis of infancy is a relatively common dermatosis in infants that is benign and self-limiting. It was identified as an individual entity in 1979 by Kahn and Rywlin [3] and by Jarratt and Ramsdell [2]. Acropustulosis of infancy entails outbreaks of pruriginous vesicles and pustules sited mainly on the extremities of the limbs, specifically the lateral surfaces and the backs of the hands and feet. The palms and the soles, the other segments of the limbs and, in fact, any part of the external surface of the body can be affected, although these incidences are much less significant.

The onset consists of small macules and papules which progress to form vesicles and then pustules of 1 - 3 mm in diameter. These pustules, which do not tend to coalesce, dry out in a few days to leave behind, especially in the darker skinned infants who are most often affected, hyperpigmentation that is most likely temporary. Bouts of acropustulosis, which are pruriginous, last between two and three weeks and they recur at varying intervals.

Acropustulosis of infancy develops in the first year of life, and in rare cases it is present from birth. It resolves spontaneously around the age 2 or 3 years. The aetiology of acropustulosis of infancy is unknown; the condition is isolated, without any links to other dermatoses or abnormalities affecting structures other than the skin. This point may need to be emphasised to the family: aside from the pruritus being unpleasant, this condition has no particular consequences.

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