Table 3.
Skin diseases mimicking DCM.
| Disease | Skin Lesions Resembling DCM | Main Clinical Features of the Disease |
|---|---|---|
| Staphylococcal scalded skin syndrome (SSSS) | Blistering Redness of the entire skin Desquamation of the skin |
Denudation of the skin caused by exotoxin produced by phage group II strains of Staphylococcus species Usually presents 48 h after birth (rare in children older than six years) Culture from the site of the suspected primary infection is warranted |
| Epidermolysis bullosa (EB) | Generalized bullous eruptions | Genetic collagen disorder is characterized by skin fragility leading to blistering, wounds, and scarring Identification of typical gene mutations |
| Impetigo bullosa (IB) | Small vesicles that can grow into tense bullae and erosions | Superficial, highly contagious bacterial (Staphylococcus aureus and Streptococcus pyogenes) skin infection Pustules, blisters, and honey-colored crusted erosions Bacterial cultures can be used for confirmation of a diagnosis |
| Erythema multiforme (EM) | Blisters based on erythematous skin lesions | Target-like lesions present symmetrically on the extremities (especially on extensor surfaces) and spread centripetally Precipitating factors: infections, especially the herpes simplex virus, and medications Histology: vacuolar interface dermatitis with marked infiltration with lymphocytes along the dermo-epidermal junction |
| Atopic dermatitis | Pruritic rash, erythroderma in severe cases | A defect in the skin barrier causes xerosis. Severe pruritus In infants, edematous papules and plaques that may have vesicles or crust on the scalp, face, and extensor extremities |
| Langerhans cell histiocytosis | Extensive rush and blistering in infants | Clonal disease of the monocyte-macrophage system A wide spectrum of skin lesions Histology with immunophenotyping: accumulation of CD1a-positive and/or CD207-positive dendritic cells |
| Linear IgA bullous dermatosis | Plaques and papules with blistering | Widespread annular blisters that exhibit a predilection for the lower abdomen, thighs, and groin Direct immunofluorescence: linear IgA deposits on the basement membrane zone |
| Incontinentia pigment | Blistering rash | Blistering, present in the early stages of infancy, heals spontaneously Blistering stage, followed by the development of verrucous lesions verrucous lesions and hyperpigmentation Coexisting signs: hair loss (alopecia) and dental abnormalities |