Acropustulosis of infancy is an intensely itchy rash that occurs on the hands and feet of infants. The rash is commonly located along the edge of hands and feet and may extend to the palms and soles. The lesions start out as red bumps or blisters that become white or yellow if they fill with pus. The exact cause is unknown, but it may occur in association with a scabies infection and represent an allergic reaction to the scabies mite.
This condition usually presents after 10 months of life and typically clears within a few weeks. Crops of lesions may recur over months to years, but it usually resolves by age three. After the lesions heal, there may be darker pigmented areas which represent where inflammation in the skin used to be. This is called post-inflammatory hyperpigmentation and it will resolve with time.
This condition is usually self-limiting, and treatment is geared toward relieving symptoms. Oral antihistamines such as Benadryl and topical corticosteroids are used to help with the itching. In refractory cases, oral antibiotics with anti-inflammatory properties such as dapsone may be an option as well. If it is in association with scabies, treatment of the underlying infection should lead to resolution.
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