exanthem, unilateral laterothoracic

Unilateral laterothoracic exanthem (ULE) is a puzzling rash that I have only seen a few times. It begins in the areas around the armpit (axilla), the side of the trunk, upper inner arm, or groin. It tends to extend farther out the extremities and down the body (cetrifugal extension). It is also known as "asymmetric periflexural exanthem of childhood."

ULE is usually characterized by its asymmetric, one-sided onset, beginning close to the arm pit (axilla), lateral trunk, upper inner arm, or groin. It often extends across the body to involve the other side. Over half the patients complain of itching. The lesions are small, distinct papules with a pale halo; they progress through a darker phase and then become scaly.

It is assumed this rash has a viral cause, but the actual causative virus is not known. Other rashes it may resemble to some degree include Gianotti-Crosti syndrome and pityriasis rosea, two other distinctive exanthems that are benign, self limited, occur mainly or exclusively in children, and are presumed to be caused by viral infection.

The disease runs its course in about 4-6 weeks; there is no specific treatment known, or even needed.

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