Advances in pediatric dermatitis

Las Vegas

- Kawasaki disease (KD), also called mucocutaneous lymph node syndrome, is the most common cause of acquired cardiac disease in children, and it is important to understand its pathogenesis in order to diagnose and treat the child, says Sheila Fallon Friedlander, M.D., clinical professor, pediatrics and medicine, University of California San Diego Medical Center, Rady Children’s Hospital, San Diego.

KD has an unknown etiologly. It may be toxin-mediated or caused by a viral infection. KD is a serious disease of infants and children younger than 10 years of age, and is very uncommon in older children and adults.

KD is marked by a variable, nonbulous rash and fever lasting more than five days, conjunctivitis without discharge, reddened mucous membranes, "strawberry" tongue, cervical lymphadenopathy, and erythema/edema of palms and soles, as well as desquamation.

Palmer dysquamation occurs late in the progression of the disease, so it is best to diagnose the disease before scaling appears, Dr. Fallon Friedlander says.If fever persists for five days or more in a child under age 10, and four of the five characteristics for KD are present, lab tests can help confirm diagnosis, she tells Dermatology Times.

For example, c-reactive protein (CRP) levels 3 mg/Dl or greater and sed rates of 40 mm/hr or greater may indicate KD.Children with KD are likely to develop micropustullar follicular rash, as well as intercurrent or post disease psoriasis.

Once diagnosis is made, the doctor must intervene quickly.Treatments for KD include IVIG therapy, aspirin, corticosteroids, and biologics, Dr. Fallon Friedlander says.DT