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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