[Cutaneous manifestations of Kawasaki disease. Apropos of 30 cases]

Abstract

A series of 30 cases of Kawasaki disease has been studied retrospectively over a period of 11 years. The aim was to reassess the diagnostic value of the dermatological manifestations. A modification of the extremities was observed in 28 patients (23 had early inflammatory lesions, 25 had late desquamation). Exanthema was constant, polymorphous and most often urticaria-like. Vesicles, pustules or purpura were noted during the course of the eruption in 7 patients. A perineal eruption was observed in 17 cases and was found of good diagnostic value even though not pathognomonic. Cheilitis was the most frequent of buccopharyngeal modifications (93 p. 100). Conjunctival hyperemia was noted in 26 patients. Eight children had cardiovascular complications. Among these cases, the modification of the extremities seemed to be more pronounced and stomatitis and arthritis were apparently more frequent. Most of all, the inflammatory syndrome was significantly more severe as concerns CRP and polymorphonuclear leukocytes counts. Dermatological examination often rules out other diagnoses, such as measles, scarlet fever and staphylococcal toxic shock syndrome. However, a complete etiological workup remains mandatory.