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Acropustulosis of Infancy

Last updated Sept. 13, 2019

Approved by: Maulik P. Purohit MD, MPH

Acropustulosis of Infancy is a skin condition that affects young children. It is characterized by small and itchy blisters on the soles of the feet and palms of the hands.


What are the Other Names for this Condition? (Also known as/Synonyms)

  • Infantile Acropustulosis
  • Pediatric Acropustulosis

What is Acropustulosis of Infancy? (Definition/Background Information)

  • Acropustulosis of Infancy is a skin condition that affects young children. It is characterized by small and itchy blisters on the soles of the feet and palms of the hands
  • The exact cause of Acropustulosis of Infancy is not known. However, it is possible that the condition occurs as a result of an allergic reaction to scabies mites (tiny parasitic insects). These mites cause scabies that is a highly-contagious skin infection
  • The diagnosis is usually made based on the characteristic symptoms of the condition; if needed, a tissue biopsy may be performed for confirmation
  • Treatment for Acropustulosis of Infancy typically includes topical creams and medications including steroids, oral antihistamines, and dapsone
  • The prognosis for children with Acropustulosis of Infancy is generally favorable. The condition typically resolves when the child reaches the age of 3 years

Who gets Acropustulosis of Infancy? (Age and Sex Distribution)

  • Acropustulosis of Infancy is a condition affecting very young children, generally in their first 2-3 years of life
  • Both genders (boys and girls) are affected by this condition
  • The exact prevalence of this condition is not known. However, Acropustulosis of Infancy has been reported worldwide, across all races and ethnicities

What are the Risk Factors for Acropustulosis of Infancy? (Predisposing Factors)

The risk factors for Acropustulosis of Infancy may include:

  • Allergy to scabies mites
  • Pre-existing atopic dermatitis (an itchy skin disorder that is non-contagious)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acropustulosis of Infancy? (Etiology)

  • The exact cause of Acropustulosis of Infancy is not entirely understood
  • However, there is compelling evidence to suggest that the condition precedes a scabies infection, and is a result of an allergic reaction to the scabies mite

Note: Mutations in the gene coding for interleukin-1 receptor antagonist (also known as deficiency in interleukin-1 receptor antagonist or DIRA) can cause symptoms that resemble Acropustulosis of Infancy. However, unlike Acropustulosis of Infancy, DIRA is an autoinflammatory condition, affecting the skin, bones, and other organs, and can be life threatening.

What are the Signs and Symptoms of Acropustulosis of Infancy?

The signs and symptoms of Acropustulosis of Infancy may include the following:

  • Intense and itchy rashes on the hands and feet
  • The rashes most commonly affect the edges of the hands and feet
  • Red bumps or blisters, which may become yellow or white
  • Presence of dark pigmented areas on the skin

The signs and symptoms of a scabies infection may include tiny bite-like rashes that appear in a variety of body parts, such as:

  • In between the fingers
  • On the inner aspects of the wrists and elbow
  • On the soles of the hand and feet
  • Around the knee joints
  • Around the armpits
  • Around the breasts and back of the shoulder
  • Around the waist region
  • Around genital area and buttocks

How is Acropustulosis of Infancy Diagnosed?

The diagnosis of Acropustulosis of Infancy is made on the basis of the following tests and exams:

  • A physical examination and assessment of symptoms
  • A complete blood count, which will likely reveal high amounts of eosinophils, suggesting inflammation and an allergic reaction
  • Cultures may be performed to help rule out the possibility of an infectious disease
  • A tissue biopsy may be performed to confirm a diagnosis
  • Differential diagnosis to eliminate other conditions that may present with similar symptoms may be undertaken

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the Possible Complications of Acropustulosis of Infancy?

Acropustulosis of Infancy is a self-limiting condition and no major complications have been generally reported

  • However, the condition has been found to recur in some individuals over months and years
  • Owing to inflammation, the lesions may present hyperpigmented areas once they heal

How is Acropustulosis of Infancy Treated?

Acropustulosis of Infancy is usually self-limited and resolves on its own in a few weeks. It is generally not responsive to therapy, although the use of the following treatments may be recommended:

  • Antihistamines
  • Topical steroids
  • Dapsone

If a scabies infection is detected, successful treatment of the underlying infection may aid in clearing Acropustulosis of Infancy.

How can Acropustulosis of Infancy be Prevented?

  • Currently, there are no known methods or guidelines available for the prevention of Acropustulosis of Infancy
  • In children with atopic dermatitis, seeking medical attention for the same may help prevent Acropustulosis of Infancy

Additionally, the following steps can minimize the spread of scabies, since acropustulosis is reported to precede scabies, in some cases:

  • Avoiding direct skin-to-skin contact with the infected individuals
  • Sharing of clothes and bed with infected individuals should be discouraged
  • Simultaneous treatment of all household members, along with those infected, to avoid the spread of scabies
  • Machine-washing the clothes and bed used by the infected individuals with hot water; the clothes may also be dry-cleaned. Items that cannot be washed, should be sealed in a plastic bag and kept away for a couple of weeks, to kill the mites
  • Cleaning the rooms used by the infected individual thoroughly
  • Getting pets (if any) screened for animal scabies

What is the Prognosis of Acropustulosis of Infancy? (Outcomes/Resolutions)

  • The prognosis for Acropustulosis of Infancy is mostly favorable. The condition is self-limiting and typically clears in a few weeks
  • Most cases are known to resolve before or by age 3
  • Also, there are no major complications associated with this skin condition

Additional and Relevant Useful Information for Acropustulosis of Infancy:

  • Scabies is a highly-contagious skin infection caused by a tiny parasitic insect Sarcoptes scabiei. It causes intense itching and small, raised, red spots on the affected skin area

The following resource can help you understand scabies:

https://www.dovemed.com/diseases-conditions/scabies/

What are some Useful Resources for Additional Information?


References and Information Sources used for the Article:


Helpful Peer-Reviewed Medical Articles:


Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: June 6, 2017
Last updated: Sept. 13, 2019