Infantile acropustulosis is an inflammatory, neutrophilic dermatosis of the palms and soles, seen primarily in children in the first 1–2 years of life. The diagnosis is usually clinical—identified by recurrent crops of vesicopustules developing over the palms and soles extending up over the dorso-ventral margin and wrist, but not onto the rest of the body. Lesions can be triggered by scabies or hand-foot-mouth disease. Identification of the former and therapy of the same may be necessary. Therapy traditionally involves usage of mid- to high-potency topical corticosteroids. Systemic dapsone has been used, but dosages are limited by hemolysis and careful G6PD screening is needed, given that deficiency is an X-linked recessive disorder in Black, Middle Eastern, and Asian children. Resolution by age 3 is generally universal.
KeywordsInfantile acropustulosis Inflammatory Neutrophilic dermatosis Palms Soles Vesicopustules Dorso-ventral margin
- 4.Mancini AJ, Frieden IJ, Paller AS. Infantile acropustulosis revised: history of scabies and response to topical corticosteroids. Pediatr Dermatol. 1998;15:337–41.Google Scholar
- 13.Minkis K, Aksentijevich I, Goldbach-Mansky R, Magro C, Scott R, Davis JG, Sardana N, Herzog R. Interleukin 1 receptor antagonist deficiency presenting as infantile pustulosis mimicking infantile pustular psoriasis. Arch Dermatol. 2012;148:747–52.