目的:这篇综述从最近发表的文献中提供了儿科人群感染后皮疹的最新信息。
结果:COVID-19大流行及其后遗症仍然是儿科感染性皮疹研究的重点。儿童多系统炎症综合征(MIS-C)和反应性感染性粘膜皮肤疹(RIME)是儿科人群中SARS-COV-2感染的常见并发症。大多数MIS-C病例显示低死亡率,并提示皮肤粘膜症状与COVID-19疾病严重程度无关。儿童丘疹性肢端皮炎病例,也被称为Gianotti-Crosti,也有报道与SARS-COV-2有关,并且可以类似地表现为对其他病毒感染的反应,如传染性软疣,称为Gianotti-Crosti综合征样反应(GCLR)。感染后皮疹的其他相关研究包括葡萄球菌性烫伤样皮肤综合征(SSSS)的管理更新,有较新的证据主张β-内酰胺单药治疗而不使用克林霉素,并减少了辅助测试。最后,由于吲哚毛癣菌引起的抗真菌耐药性的出现是一个日益增长的全球健康问题,强调需要改善抗真菌管理。
结论:临床医生应谨慎地了解最近与COVID-19大流行相关的常见和罕见诊断,除了其他疾病与新的循证建议,以指导管理。
OBJECTIVE: This review provides updates on postinfectious skin rashes in the pediatric population from recently published literature.
RESULTS: The COVID-19 pandemic and its sequelae remain a focus of research on pediatric infectious skin rashes. Multisystem inflammatory syndrome in children (MIS-C) and reactive infectious mucocutaneous eruption (RIME) are common complications of infection with SARS-COV-2 in the pediatric population. Most cases of MIS-C show low mortality and suggest mucocutaneous symptoms do not correlate with COVID-19 disease severity. Cases of papular acrodermatitis of childhood, also known as Gianotti-Crosti, have also been reported in association with SARS-COV-2, and can present similarly in reaction to other viral infection like molluscum contagiosum, known as a Gianotti-Crosti syndrome-like reaction (GCLR). Other relevant studies on postinfectious skin rashes include updates on the management of staphylococcal scalded skin syndrome (SSSS), with newer evidence advocating for beta-lactam monotherapy without clindamycin and reduced ancillary testing. Finally, the emergence of antifungal resistance due to Trichophyton indotinae is a growing global health concern emphasizing the need for improved antifungal stewardship.
CONCLUSIONS: It is prudent for clinicians to be informed of both common and rare diagnoses that have emerged more recently in association with the COVID-19 pandemic, in addition to other diseases with newer evidence-based recommendations to guide management.