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Es una afección cutánea de la niñez que puede estar acompañada de síntomas leves como fiebre y malestar. También puede estar asociada con hepatitis B y otras infecciones virales.

CausasLa causa de la acrodermatitis no se comprende del todo bien, pero su relación con otras infecciones está bien documentada.

En los niños italianos, la acrodermatitis se observa frecuentemente con la hepatitis B, pero dicha asociación rara vez se ve en los Estados Unidos. El virus de Epstein- Barr (VEB, mononucleosis) es el que se asocia con más frecuencia con la acrodermatitis. Otros virus conexos abarcan: citomegalovirus, virus de coxsackie, virus de la parainfluenza, virus sincicial respiratorio (VSR) y algunas vacunas elaboradas con virus vivos.

Una forma genética rara de acrodermatitis es la acrodermatitis enteropática. En este trastorno, el zinc se absorbe de manera deficiente de la alimentación. Agregar suplementos de zinc a la dieta mejora la afección. Esta forma del trastorno puede estar asociada con otras anomalías y retrasos en el desarrollo.

Síntomas•Salpullido o parche en la piel

•Parche de color marrón-rojo o cobrizo que es firme y plano en la parte superior

•Se pueden presentar hileras de protuberancias en fila

•Generalmente no hay picazón

•El salpullido (erupción) luce igual en ambos lados del cuerpo

•El salpullido puede aparecer en las palmas de las manos y las plantas de los pies, mas no en la espalda, el pecho o el área ventral (ésta es una de las formas como se le identifica, por la ausencia del salpullido del tronco del cuerpo)

Otros síntomas que pueden aparecer son:

•Abdomen inflamado

•Ganglios linfáticos inflamados

•Ganglios linfáticos sensibles

Pruebas y exámenesEl médico puede diagnosticar esta afección simplemente observando la piel y el salpullido. Se puede presentar inflamación del hígado, del bazo y de los ganglios linfáticos.

Los siguientes exámenes se pueden llevar a cabo para confirmar el diagnóstico o para descartar otras afecciones:

•Nivel de bilirrubina

•Serología para el virus de la hepatitis o antígenos de superficie para la hepatitis B

•Enzimas del hígado ( pruebas de la función hepática)

•Exámenes para anticuerpos contra el VEB

•El nivel de zinc en suero se puede analizar en la acrodermatitis enteropática

•Biopsia de piel

TratamientoLa acrodermatitis en sí no se trata, pero las enfermedades asociadas con esta afección, como la hepatitis B y el virus de Epstein-Barr, se deben tratar apropiadamente.

La acrodermatitis enteropática mejora cuando los niveles de zinc retornan a la normalidad.

PronósticoLa acrodermatitis por lo general desaparece por sí sola sin tratamiento ni complicaciones; sin embargo, las enfermedades conexas se deben vigilar cuidadosamente.

Posibles complicacionesLas complicaciones ocurren por las enfermedades asociadas más que como resultado de la acrodermatitis.

Cuándo contactar a un profesional médicoConsulte con el médico si su hijo tiene signos de esta afección.

Nombres alternativosSíndrome de Gianotti-Crosti; Acrodermatitis papular de la niñez; Acrodermatitis papular infantil; Síndrome papulovesicular acro-localizado; Acrodermatitis liquenoide infantil; Acrodermatitis enteropática

ReferenciasMore JG. Nutritional Dermatoses. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 670.

Browning J, Levy M. Papules, Nodules, and Ulcers. In: Long SS, Pickering LK, Prober CG. Principles and Practice of Pediatric Infectious Diseases.3rd ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008: chap 77.,Medline Plus.

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