Dermatology Book

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Perianal Streptococcal Dermatitis

Aka: Perianal Streptococcal Dermatitis, Perianal Streptococcal Cellulitis, Chronic Perianal Cellulitis
  1. See Also
    1. Diaper Dermatitis
    2. Erysipelas
  2. Epidemiology
    1. Affects children ages 6 months to 10 years
  3. Cause
    1. Group A Beta-hemolytic Streptococcus
  4. Risk Factors: Exposure to infection
    1. Group A Streptococcus Pharyngeal Carrier
    2. Impetigo
  5. Symptoms
    1. Painful Defecation
    2. Blood streaked stools associated with Anal Fissures
    3. Perianal Pruritus
  6. Signs
    1. Bright red, sharply demarcated perianal rash
    2. Local spread to genitalia may occur
    3. No associated fever or systemic signs
    4. Yellow crust or mucoid discharge may be present
  7. Differential Diagnosis
    1. Irritant Diaper Dermatitis
    2. Candida Diaper Dermatitis
    3. Pinworm Infestation
    4. Seborrheic Dermatitis
    5. Inflammatory Bowel Disease
  8. Labs
    1. Rapid Strep Test or Strep culture of perianal area
  9. Management
    1. Systemic antibiotics
      1. No Penicillin Allergy
        1. Penicillin or
        2. Amoxicillin 40 mg/kg/day divided tid for 10 days or
      2. Penicillin Allergy
        1. Clindamycin or
        2. Erythromycin
    2. Topical antibiotic
      1. Mupirocin (Bactroban) 2% tid for 10 days
  10. References
    1. Brilliant (2000) Am Fam Physician 61(2):391-7 [PubMed]

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