AcrodynyT56.11

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 09.07.2024

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Synonym(s)

Acrodynia; Feer's disease; neurosis vegetative of infants; pink disease; Pink Disease; rare swift-feers disease; Swift Syndrome; vegetative neurosis of infants

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HistoryThis section has been translated automatically.

E.Feer 1923

DefinitionThis section has been translated automatically.

Today rare, probably caused by mercury intoxication, brain stem encephalopathy with skin and multiple organ symptoms in small children.

ManifestationThis section has been translated automatically.

25 months to 7 years of age.

Clinical featuresThis section has been translated automatically.

Initial changes in character: tearfulness, increasing apathy, possibly trichotillomania. After 2-4 weeks cold, moist, cyanotic, swollen hands and feet with coarse lamellar palmoplantar desquamation. Possibly generalized, itchy erythema. Severe hyperhidrosis up to miliaria rubra. In severe cases diffuse alopecia, loss of nails and teeth. Internal symptoms: tachycardia, arterial hypertension, marked fluctuations in blood sugar levels, generalized muscle weakness, sleep disturbances, weight loss. Photophobia, conjunctivitis. Possibly painful paresthesias. The children constantly rub their hands and feet, automutilation occurs.

LaboratoryThis section has been translated automatically.

mercury in both senses of the word.

Differential diagnosisThis section has been translated automatically.

Erythema scarlatiniforme desquamativum recidivans.

TherapyThis section has been translated automatically.

Avoid mercury. For acute inorganic mercury intoxication: Dimercaprol (DMPS, e.g. Dimaval). Drinking egg milk, emetic, gastric lavage, plasma expander, haemodialysis, antibiotics. For chronic intoxication with organic mercury: N-acetylcysteine. If necessary, several weeks trial with DMPS. Experimental vitamin B administration. Specific chelating agents ( D-penicillamine) to promote mercury excretion, see below. antidote.

LiteratureThis section has been translated automatically.

  1. Boyd AS et al (2000) Mercury exposure and cutaneous disease. J Am Acad Dermatol 43(1 Pt 1): 81-90
  2. Dinehart MD et al. (1988) Cutaneous manifestation of acrodynia (pink disease). Arch Dermatol 124: 107-109

  3. Feer E (1923) On a peculiar neurosis of the vegetative system in infants. Erg.d inn Med u Kinderheilk 24

  4. Havarinasab S et al. (2004) Dose-response study of thimerosal-induced murine systemic autoimmunity. Toxicol Appl Pharmacol 194: 169-179
  5. Horowitz Y et al (2002) Acrodynia: a case report of two siblings. Arch Dis Child 86: 453
  6. Rütter A et al (1996) Metal dermatoses II. Dermatology 47: 400-409

  7. Shekhawat R et al (2022) Acrodynia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. PMID: 32644540.

Authors

Last updated on: 09.07.2024

Author: Prof. Dr. med. Peter Altmeyer