Acrodyny T56.11

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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

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25. month of life to 5. year of age.

Clinical features
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Initial changes of character: weepiness, increasing apathy, possibly trichotillomania. After 2-4 weeks cold, damp, cyanotic, swollen hands and feet with coarse lamellar palmoplantar desquamation. Possibly generalized, itchy erythema. Severe hyperhidrosis up to miliaria rubra. In severe cases loss of hair, nails and teeth. Internistic symptoms: tachycardia, arterial hypertension, strong fluctuations in blood sugar levels, general muscle weakness, sleep disorders, weight loss. Photophobia, conjunctivitis. Possible painful paresthesias. The children constantly rub hands and feet, automutilation occurs.

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mercury in both senses of the word.

Differential diagnosis
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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.

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


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Last updated on: 29.10.2020