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Perianal Dermatitis in a Child
Leonardo Bugatti, MD;
Giorgio Filosa, MD;
Giovanni Ciattaglia, MD
"A. Murri" Hospital, Iesi, Italy
Arch Dermatol. 1998;134:1145-1150.
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REPORT OF A CASE
An otherwise-healthy 12-year-old boy presented with a 1-month history of perianal irritation and discharge. Previous therapy included topical antifungal agents. Physical examination revealed sharply demarcated perianal erythema with pustules, edema rimmed with hyperpigmentation, and mucopurulent exudation (Figure 1). There was no palpable inguinal lymphadenopathy. The pharynx was normal. None of his family members had similar lesions.
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Figure 1.
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A rectal examination revealed no abnormalities. A culture was obtained and the results are shown in Figure 2.
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Figure 2.
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What is your diagnosis?
Diagnosis: Perianal streptococcal dermatitis (PSD).
Group A  -hemolytic streptococci were isolated from a perineal swab. A streptozyme test was positive at a titer of 1:400, and the antistreptolysin O antibody level was 850 U/L (normal, <250 U/L). The patient was allergic to erythromycin, so oral amoxicillin was administered (50 mg/kg per day) for 10 days, with rapid resolution of the patient's . . . [Full Text of this Article]
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