A Case of a Junior High School Student with Kawasaki Disease Showing Many Small Pustules

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  • 小膿疱を伴った中学生の川崎病
  • 症例 小膿疱を伴った中学生の川崎病
  • ショウレイ ショウノウホウ オ トモナッタ チュウガクセイ ノ カワサキビョウ

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<p>A 14-year-old boy had suffered from Kawasaki disease. From 8 days before the first visit, his fever reached the 38 ℃ range, erythema of the limbs appeared 5 days before, and pustules appeared throughout the body 1 day before. Leukocytosis with leftward movement, elevated serum C-reactive protein, and mild jaundice were observed. The histopathological findings of the pustules showed subcorneal pustules with neutrophils. Echocardiography was normal. Gamma globulin and aspirin were administered, and desquamation was confirmed on the limbs. Pustules are the main diagnostic criterion of Kawasaki disease, but the frequency of reports of Kawasaki disease accompanied by pustules has been decreasing in recent years. It seems that an effective treatment regime has been established for Kawasaki disease and the therapy is usually started before the appearance of pustules. In older children, Kawasaki disease with small pustules is difficult to distinguish from acute generalized eruptive pustulosis, and the start of treatment tends to be delayed. If steroid alone is administered for Kawasaki disease, the risk of a coronary artery lesion increases. Therefore, prevention of the sequela of heart failure should be given priority.</p>

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