Asymmetric periflexural exanthema

Brunner 1962, Bodemer and de Prost 1992, Taieb 1993.

Unilaterales laterothorakales Exanthem, ULE, asymmetrisches Exanthem, asymmetrisches periflexurales Exanthem der Kindheit, APEC.

Self-limiting, 4-6 weeks lasting, probably infectious allergic skin disease of childhood.

• Very rare occurrence.
• Highest incidence in the 2nd-3rd year of life, but an onset of the disease is still possible at the age of 10 years. Only a few diseases of adults are registered.
• Girls are affected more often than boys.
• Seasonal accumulation in the spring and summer months.
• Occasionally occurring in minor epidemics.

The triggering agent has not yet been described.

There is a good general condition. After a mildly pronounced catarrhal stage with infection of the upper airways or gastrointestinal symptoms, exanthema forms. Lens sized, scarlitiniform, partly lichenoid and confluent, erythematous, discreetly scaling papules occur mostly axillanah, rarely also inguinal partly along the blaschko lines. The efflorescences are mostly unilaterally accentuated or exclusively unilaterally arranged. After 2 weeks, it spreads to the thoracic wall or leg as well as to the contralateral side. A regional lymphadenopathy must be expected.

• Clinic.
• Laboratory is non-specific.
• Since the pathogen is unknown, detection is not yet possible.

Initially unilateral thoracoaxillary, in some cases also inguinal. Finally, spread to the contralateral side of the body. A symmetrical occurrence is also possible from the beginning in a few cases.

Discreet spongiosis, exocytosis, superficial perivascular lymphocytic dermatitis, otherwise unspecific.

Not possible.

• Self-limiting course.
• The exanthema subsides after 3 weeks and usually heals after 4-6 weeks.

1. Taïeb A, Mégraud F, Legrain V, Mortureux P, Maleville J. Asymmetric periflexural exanthem of childhood. Journal of the American Academy of Dermatology 1993;29:391-3.
2. Al Yousef Ali A, Farhi D, De Maricourt S, Dupin N. Asymmetric periflexural exanthema associated with HHV7 infection. Eur J Dermatol 2010;20:230-1.
3. Arun B, Salim A. Transient linear eruption: asymmetric periflexural exanthem or blaschkitis. Pediatr Dermatol 2010;27:301-2.
4. Drago F, Ciccarese G, Rebora A. Unilateral laterothoracic or asymmetric periflexural exanthem: is time to change the name of the disease? Clin Exp Dermatol 2015;40:570.
5. Harangi F, Varszegi D, Szucs G. Asymmetric periflexural exanthem of childhood and viral examinations. Pediatr Dermatol 1995;12:112-5.