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

• EP (Eruptive Pseudoangiomatosis)
• EPA (Eruptive Pseudoangiomatosis)
• Pseudoangiomatosis Eruptiva

What is Eruptive Pseudoangiomatosis? (Definition/Background Information)

• Eruptive Pseudoangiomatosis (EP or EPA) is a rare skin condition that is believed to be caused by several virus types. It results in the rapid formation of skin eruptions in the form of tiny red papules, on the arms, legs, face, and neck region
• The disease affects both children and infants. The risk factors for Eruptive Pseudoangiomatosis are not well-defined, but may include insect bites and poor immunity
• The condition may be asymptomatic in many individuals and no complications are generally noted. A skin biopsy may be performed towards establishing the diagnosis of Eruptive Pseudoangiomatosis
• Treatment for Eruptive Pseudoangiomatosis is provided as necessary, and may include administration of antiviral drugs and undertaking treatment for any underlying condition causing poor immunity
• The prognosis for Eruptive Pseudoangiomatosis is good in many cases, since it is a benign condition. The skin condition resolves by its own in many individuals, usually within 1-3 months (sometimes earlier in children)

Who gets Eruptive Pseudoangiomatosis? (Age and Sex Distribution)

• Eruptive Pseudoangiomatosis is an uncommon disease that can be seen in individuals of any age category including children and adults. Many cases are known to involve children
• Both males and females are affected and no gender preference is noted; some studies indicate a female predilection
• Individuals of all racial and ethnic backgrounds have the same risk for infection

What are the Risk Factors for Eruptive Pseudoangiomatosis? (Predisposing Factors)

The risk factors for Eruptive Pseudoangiomatosis are not well-established, but the following factors are thought to be involved:

• Immunocompromised states: Individuals, who have poor immune system, are at an elevated risk for infection. This may occur from:
  • Prolonged hospitalization
  • Cancer therapy
  • Organ transplant necessitating immunosuppression
• Insect bites such as mosquito bites

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 Eruptive Pseudoangiomatosis? (Etiology)

Eruptive Pseudoangiomatosis is a skin condition of unexplained cause that shows the involvement of a variety of virus types. The following have been implicated with EPA:

• Echovirus 25, 32
• Coxsackie B virus
• Adenovirus
• Cytomegalovirus (CMV)
• Epstein-Barr virus (EBV)

What are the Signs and Symptoms of Eruptive Pseudoangiomatosis?

The signs and symptoms of Eruptive Pseudoangiomatosis may include:

• Sudden onset of minute red papules over the skin
• The papules are usually 2-4 mm in size
• The skin lesions appear like benign angiomas that blanch when pressed (and hence a differential diagnosis to eliminate angiomas is normally undertaken)
• The condition is usually asymptomatic, but may be itchy
• The skin rashes are seen more on the extremities (arms and legs) than the head and neck region
• Eruptive Pseudoangiomatosis is not associated with fever and fatigue
• The red skin rash may lead to blister formation, which is followed by ulceration
• Enlarged lymph nodes (lymphadenopathy) is usually not seen

In some individuals, the condition can be chronic and recurrent (it can come and go over time).

How is Eruptive Pseudoangiomatosis Diagnosed?

The diagnosis of Eruptive Pseudoangiomatosis may involve the following tests and exams:

• A complete physical examination and analysis of past medical history by a healthcare provider
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Viral culture: A culture may be performed to confirm the presence of virus and to rule-out other causes of infection. In this culture, a small amount of pus or fluid from one of the sores is collected and sent to the lab for testing. The test results can help confirm the presence and type of virus (if any present)
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• Differential diagnosis of the following skin conditions/tumors presenting similar symptoms should be ruled out:
  • Bacillary angiomatosis
  • Cherry hemangioma
  • Eruptive angiomatosis
  • Telangiectasias

 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 Eruptive Pseudoangiomatosis?

No significant complications of Eruptive Pseudoangiomatosis are noted. However, in some individuals the following are observed:

• Bacterial superimposed infections over the skin lesions; this secondary bacterial infection can result in septicemia
• Recurrent Eruptive Pseudoangiomatosis - rarely, the symptoms may appear and disappear (‘come and go’)
• Individuals with weak immune systems may develop additional complications

How is Eruptive Pseudoangiomatosis Treated?

The following treatment options for Eruptive Pseudoangiomatosis may include:

• Administration of anti-viral medications
• Topical skin ointments and creams
• Treating any underlying immunocompromised state (if present)
• Antibiotic medication for any secondary bacterial infections

In many individuals, the condition may get better on its own, without any treatment.

How can Eruptive Pseudoangiomatosis be Prevented?

In general, it may not be possible to prevent Eruptive Pseudoangiomatosis; nevertheless, the following measures may be considered:

• Preventing the triggers for underlying risk factors
• Undertaking appropriate and adequate treatment of any underlying condition (that may be a risk factor for Eruptive Pseudoangiomatosis), as instructed by the healthcare provider
• Practicing good and regular hand washing techniques, to prevent spread of the virus
• Avoiding individuals, who have cold sores or other such infections
• Covering one’s mouth during coughing or sneezing
• Avoid exposure to or direct contact with individuals who are infected 

What is the Prognosis of Eruptive Pseudoangiomatosis? (Outcomes/Resolutions)

• Eruptive Pseudoangiomatosis has a good prognosis, since it is a benign and self-limiting condition in many cases
• The skin symptoms are reported to disappear within 2-18 days in children; and in adults, within 1-3 months

Additional and Relevant Useful Information for Eruptive Pseudoangiomatosis:

• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for Eruptive Pseudoangiomatosis. However, it helps to be clean and hygienic, which will help the condition from getting worse