Differential diagnosis
The differential diagnosis for APEC includes viral exanthems, eczema, scabies, pityriasis rosea, contact dermatitis, and miliaria (heat rash). APEC mainly affects children aged 2 to 3 years but can occur at a younger age. There are no laboratory tests that help establish the diagnosis of APEC. The diagnosis is based on the clinical picture of an asymmetric macular and papular exanthem in a young child with a viral-like prodrome.
Treatment and outcome
There is no specific treatment for APEC other than to treat the symptoms. No treatment has been shown to shorten the course of this disease. A low-potency topical steroid along with an antihistamine provides adequate symptomatic treatment.
This child had no significant symptoms and therefore no medications were prescribed. The parents were told they may get 1% hydrocortisone cream over-the-counter if their daughter developed troublesome itching. Reassurance was provided about the limited nature of this exanthem. The parents were advised to bring the child for follow-up if the rash did not completely resolve in 2 months. By the time for the child’s 1-year check-up, the rash was gone.
Corresponding Author
Amor Khachemoune, MD, CWS, Wellman Center for Photomedicine (BAR 314), Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 40 Blossom Street, Boston, MA 02114. E-mail: amorkh@pol.net.