Year: 2024
Type: article
Study design: Case Report
Abstract: Case ReportA previously well 18-month-old girl presented to a regional hospital in New South Wales with a 3-week history of a generalised rash.The rash was pruritic, erythematous, maculopapular and found on the forehead, ear lobes, torso, arms, legs and feet (Fig. 1).There was no history of fever, systemic symptoms or medication.Differential diagnoses of papular urticaria due to insect bites, infected atopic dermatitis and scabies were considered. 1 The lesions were swabbed for bacteria and viruses and she was commenced on topical steroids (betamethasone propionate and methylprednisolone aceponate), moisturiser, flucloxacillin and cetirizine, followed by topical application of permethrin.As no improvement was noted few weeks after starting treatment, we investigated her for systemic causes of pruritus including renal and hepatobiliary disease, thyrotoxicosis and a myeloproliferative disorder like Hodgkin's lymphoma.1 Results revealed normal full blood count, blood picture, renal, thyroid functions and total serum IgE.Liver function tests showed elevated alanine aminotransferase (530 U/L), aspartate transaminase (224 U/L) and bile acid (>180 μmol/L) and normal bilirubin (6 μmol/L), gamma-glutamyl transferase (GGT) (12 U/L), albumin (36 g/L) and prothrombin time.Further investigations exploring a liver pathology found negative hepatitis A, B, C and cytomegalovirus serology and normal anti nuclear antibodies (ANA), anti-dsDNA, serum copper, caeruloplasmin and alpha 1 antitrypsin genotype.Abdominal ultrasonography showed AC De Alwis and TS KumarPruritic rash
DOI: 10.1111/jpc.16676
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4402750730