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Arch Argent Pediatr 2020 08;118(4):e400-e404

Pediatría, Hospital Clínico Universitario Lozano Blesa, Zaragoza (España).

The asymmetric periflexural exanthema of childhood is an underdiagnosed entity of unknown etiology that affects, most commonly, girls around two years of age. Clinically, it affects only one side of the body and it eventually disappears without the need of any specific treatment. We report two cases of this entity. Read More

Dermatol Online J 2020 May 15;26(5). Epub 2020 May 15.

Department of Dermatology, CHU Amiens-Picardie, Amiens.

Asymmetric periflexural exanthem of childhood (APEC) is a self-limited disease characterized by unilateral exanthem. The etiology is unknown, but a viral agent is suspected. Most often there is no formal proof of an associated viral etiology, but several associations between APEC and some viruses have been described. Read More

G Ital Dermatol Venereol 2019 Dec 26;154(6):722-724. Epub 2018 Mar 26.

Division of Dermatology, U.O. Multizonale APSS, S. Chiara Hospital, Trento, Italy.

Infect Dis Rep 2016 Mar 21;8(1):6418. Epub 2016 Mar 21.

JC School of Public Health and Primary Care, The Chinese University of Hong Kong and Prince of Wales Hospital , Shatin, Hong Kong.

Many clinical and laboratory-based studies have been reported for skin rashes which may be due to viral infections, namely pityriasis rosea (PR), Gianotti-Crosti syndrome (GCS), asymmetric periflexural exanthem/unilateral laterothoracic exanthem (APE/ULE), papular-purpuric gloves and socks syndrome (PPGSS), and eruptive pseudo-angiomatosis (EP). Eruptive hypomelanosis (EH) is a newly discovered paraviral rash. Novel tools are now available to investigate the epidemiology of these rashes. Read More

Pediatr Dermatol 2010 May-Jun;27(3):301-2

University Hospitals of North Staffordshire NHS Trust, Department of Dermatology, Hartshill, Stoke-on-Trent, UK.

We report the case of a 4-year-old boy who presented with a transient extensive eczematous eruption on the left side of his trunk and extremities, with clear demarcation in the midline. The eruption started to resolve without any sequelae in 4 weeks. The history and clinical findings suggest that this transient eruption could have been either a case of unilateral blaschkitis in childhood or asymmetric periflexural exanthem. Read More

Dermatol Nurs 2007 Aug;19(4):366-7

Ronald O. Perelman Department of Dermatology, Dermatologic and Laser Surgery, Mohs Micrographic Surgery, New York University School of Medicine, New York, NY, USA.

Asymmetric periflexural exanthema of childhood is a benign, self-limiting disease of unknown origin. Patients generally present a few weeks after a viral-like prodrome with erythematous macules and papules within flexural spaces followed by centrifugal spread. Treatment focuses on alleviating symptoms of pruritus. Read More

Indian J Dermatol Venereol Leprol 2003 Nov-Dec;69(6):401-4

Skin Disease Centre, Shreeram Sankul, Opp. Hotel Panchavati, Vakilwadi, Nashik-422 002.

Asymmetric periflexural exanthem (APE) is a distinctive exanthem, probably viral in origin. It is largely a disease of childhood and is uncommon in adults. We report an adult man presenting with the typical clinical findings of APE. Read More

Clin Dermatol 2007 Mar-Apr;25(2):212-20

Sector of Dermatology, School of Medicine and HUCFF-UFRJ, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Viral exanthems are a common problem in tropical regions, particularly affecting children. Most exanthems are transient and harmless, but some are potentially very dangerous. Pregnant women and malnourished or immunocompromised infants carry the greatest risk of adverse outcome. Read More

J Eur Acad Dermatol Venereol 2006 Apr;20(4):461-2

Br J Dermatol 2004 Feb;150(2):396-7

Pediatr Dermatol 2002 Sep-Oct;19(5):461-2

J Eur Acad Dermatol Venereol 2001 Jul;15(4):372-4

J Eur Acad Dermatol Venereol 2001 Jul;15(4):293-4

Pediatr Dermatol 2000 May-Jun;17(3):169-73

Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-Bordeaux, Bordeaux, France.

Our objective was to study possible etiologic factors of asymmetric periflexural exanthem of childhood (APEC) among a large panel of microbiologic agents not yet investigated. To do so, we designed a prospective case-control study using throat, stool, blood, and skin samples, and enlisted 37 children with APEC and 37 age-matched controls without eruption seen consecutively from February 1995 to April 1996 from a mixed referral center and community-based population. No interventions were done. Read More

Ugeskr Laeger 2000 Apr;162(14):2050-1

Odense Universitetshospital, dermato-venerologisk afdeling I.

Asymmetric peri-flexural exanthem of childhood is a "new" disease, which has never been reported by Danish authors. It is characterized by an asymmetric maculopapular exanthem in early childhood. The exanthem is initially unilateral and localised close to the axilla, but it spreads centrifugally during the first week, becomes more widespread and resolves spontaneously within four to six weeks. Read More

Arch Dermatol 1999 Jul;135(7):799-803

Unité de Dermatologie Pédiatrique, Hôpital Pellegrin-Enfants, Bordeaux, France.

Objective: To assess the clinical, pathologic, and epidemiologic features of asymmetric periflexural exanthem of childhood (APEC), a clinically distinctive eruption, especially its link with pityriasis rosea and pattern of transmission.

Design: A prospective case series, including an analysis of epidemiologic triggering factors and mode of transmission. Pathologic study, including immunohistochemistry of the inflammatory infiltrate. Read More

Curr Opin Pediatr 1995 Aug;7(4):411-4

University of California at San Francisco, Department of Dermatology 94143, USA.

Childhood exanthems are a common cause of skin disease in children. Several new aspects of exanthems are reviewed. Two conditions, unilateral laterothoracic exanthem and asymmetric periflexural exanthem, may be variations of the same disease and could potentially represent a cutaneous reaction to several infectious agents. Read More

Pediatr Dermatol 1995 Jun;12(2):112-5

Kerpel-Fronius Odön Children's Hospital of Baranya County, Pécs, Hungary.

We report on an asymmetric maculopapular exanthem of early childhood. One hundred eighty seven patients (111 girls, 76 boys) were examined over a four-year period, mainly in winter and spring. The first skin lesions appeared on the trunk or in the large flexures of the limbs. Read More

Clin Exp Dermatol 1994 Sep;19(5):421

Department of Dermatology, Countess of Chester Hospital, UK.

Pediatr Dermatol 1994 Mar;11(1):42-5

Institute for Dermatological Sciences, University of Milan, IRCCS, Ospedale Maggiore, Italy.

A newly described exanthem of infancy consists of an eczematous or scarlatiniform eruption that starts initially from one axillary fold and spreads unilaterally and centrifugally on the trunk and the proximal part of the upper limb. Minor lesions are infrequently present on the contralateral side. The rash may be slightly pruritic and sometimes associated with a moderate regional lymphadenopathy. Read More

J Am Acad Dermatol 1993 Sep;29(3):391-3

Pediatric Dermatology Unit, Hôpital Pellegrin-Enfants, Bordeaux, France.

Background: We report an expanded series of patients with a distinctive childhood exanthem.

Objective: Our goal was to describe a new clinical entity.

Methods: This is a clinical study. Read More