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Akute Hautinfektionen und deren Imitatoren im Kindesalter

Ein Bilderquiz

Acute skin infections and their imitators in children

A photo quiz

  • Leitthema
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Zusammenfassung

Hintergrund

Pädiatrisch-dermatologische Notfallkonsultationen betreffen in 40 % infektiöse Hautbefunde. Es gilt, potenziell komplikationsreiche Hautinfektionen prompt zu erkennen und zu behandeln. Einige charakteristische Hautbefunde imitieren akute Hautinfektionen und werden regelmäßig fehlinterpretiert.

Ziel der Arbeit

Häufige pädiatrische Hautinfektionen sollen hier dargestellt und Fallstricke in Bezug auf Imitatoren und Differenzialdiagnose hervorgehoben werden.

Material und Methode

In Form eines Bilderquiz wird eine Auswahl akuter kindlicher Hautinfektionen in Gegenüberstellung zu infektiösen oder nichtinfektiösen Imitatoren und Differenzialdiagnosen diskutiert.

Ergebnisse

Folgende infektiöse Hautbefunde und deren Imitatoren sind hier unter Hervorhebung von klinischen Merkmalen zur Unterscheidung beschrieben: Eczema herpeticatum und bakteriell superinfizierte atopische Dermatitis, exanthematische Hand-Fuß-Mund-Krankheit und Varizelleninfektion, Erythema chronicum multilocularis und anuläre Urtikaria; Gianotti-Crosti-Syndrom und Gianotti-Crosti-artige Reaktion, bakterielle Follikulitis der Kopfhaut und Kerion Celsi respektive eosinophile pustulöse Follikulitis des Skalps, kutane Leishmaniose und idiopathisches faziales aseptisches Granulom, allergische und bakterielle Lymphangitis, bullöse Impetigo contagiosa und nichtakzidentelle Verbrühung.

Schlussfolgerungen

Eine sorgfältige Anamnese- und Hautstatuserhebung mit geübtem Blick für die hier illustrierten Differenzialdiagnosen ist essenziell, um Fallstricke bei der Beurteilung von Hautinfektionen in der pädiatrischen Notfallstation zu umgehen.

Abstract

Background

Skin infections account for 40% of emergency visits in pediatric dermatology. It is important to promptly recognize skin infections with potential complications and initiate treatment. However some characteristic skin findings may imitate skin infections and are often misdiagnosed.

Objectives

To illustrate frequent pediatric skin infections and pitfalls in view of imitators and differential diagnoses.

Materials and methods

A photo quiz is presented with the discussion of a selection of acute pediatric skin infections in comparison to their infectious or noninfectious differential diagnoses.

Results

The following infectious skin conditions and imitators are described and clinical clues for differentiation highlighted: eczema herpeticum and bacterial superinfection of atopic dermatitis; exanthematous hand, foot and mouth disease and varicella infection; erythema chronicum multilocularis and anular urticaria; Gianotti–Crosti syndrome and Gianotti–Crosti-like reaction; bacterial folliculitis of the scalp and kerion celsi and eosinophilic pustular folliculitis of the scalp; cutaneous Leishmaniasis and idiopathic facial aseptic granuloma; allergic and bacterial lymphangitis; bullous impetigo contagiosa and nonaccidental scalding.

Conclusions

Careful anamnesis and skin examination with attention to the here illustrated differential diagnoses are essential to avoid pitfalls in the evaluation of acute pediatric skin infections.

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Authors and Affiliations

  1. Abteilung pädiatrische Dermatologie, Universitäts-Kinderspital Zürich, Steinwiesstrasse 75, 8032, Zürich, Schweiz

    M. Theiler, A. Schwieger-Briel &  L. Weibel

  2. Dermatologische Klinik, Universitätsspital Zürich, Zürich, Schweiz

    M. Theiler &  L. Weibel

Authors
  1. M. Theiler
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  2. A. Schwieger-Briel
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  3. L. Weibel
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Correspondence to L. Weibel.

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Interessenkonflikt

M. Theiler, A. Schwieger-Briel und L. Weibel geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Falle von nicht mündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

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M. Theiler und A. Schwieger-Briel haben gleichermaßen zum Manuskript beigetragen.

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Theiler, M., Schwieger-Briel, A. & Weibel, L. Akute Hautinfektionen und deren Imitatoren im Kindesalter. Hautarzt 68, 774–783 (2017). https://doi.org/10.1007/s00105-017-4036-y

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