Mucocutaneous lymph node syndrome (Kawasaki’s
disease)
The
cause may be a recent parvovirus infection. The disease affects young children
whose erythema, although often generalized, becomes most marked in a glove and
stocking distribution; it may be associated with indurated oedema of the palms
and soles. Peeling around the fingers and toes is one obvious feature but is
not seen at the start. Bilateral conjunctival injection and erythema of the
lips, buccal mucosa and tongue (‘strawberry tongue’) are common.
The
episode is accompanied by fever and usually resolves within 2 weeks. Despite
its name, not all patients have lymphadenopathy. The danger of this condition
lies in the risk of developing myocarditis and coronary artery disease. The
pathology is close to that of polyarteritis nodosa. Aspirin and intravenous
gammaglobulin are the mainstay of treatment; both should be given early in the
disease and reduce the risk of coronary artery involvement.
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