Abstract
Eczema and skin infections are commonly encountered in children in the outpatient department. However, presence of both recurrent dermatitis and skin infections should alarm one to consider Hyper IgE syndrome (HIES) as a differential. Here we present a case of HIES in a two and a half year old female child with history of recurrent dermatitis and skin infections in the form of cold abscesses. Laboratory investigations showed markedly elevated IgE levels and high absolute eosinophils counts. Patient was treated with trimethoprim-sulfamethoxazole and supportive care. The current report highlights the fact that HIES can present in early childhood with just skin manifestations and without any significant pulmonary manifestations.J Nepal Paediatr Soc 2015;35(1):59-61
Highlights
Eczema and skin infec ons are commonly encountered in children in the outpa ent department
Hyper IgE syndromes are a group of rare primary immunodeficiency disorders characterized by marked eleva ons in IgE levels, recurrent staphylococcal skin infec ons, recurrent pneumonia and chronic eczematoid derma s1
The skin infec ons are in the form of boils and furuncles which typically lack the signs of inflamma on, referred to as “cold abscesses”
Summary
Eczema and skin infec ons are commonly encountered in children in the outpa ent department. Presence of both recurrent derma s and skin infec ons should alarm one to consider Hyper IgE syndrome (HIES) as a differen al. The child presented to the paediatric outpa ent department with complaints of severe pruri s over face, hands, abdomen, ears and face since the age of 18 months and cold abscesses on bu ock and thighs. The child had frequent upper respiratory tract infec ons requiring hospital outpa ent visits. She was admi ed once with acute lower respiratory infec on needing intravenous an bio cs, the chest radiograph did not reveal any significant findings.
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