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Images in paediatrics
A case of recurrent toxin-mediated perineal erythema
  1. Rachida El Bouch1,3,
  2. Pauline Reubsaet2,
  3. Klaas Koop3,
  4. Jurgen Jansen3
  1. 1 Sint Lucas Andreas Hospital, Amsterdam, The Netherlands
  2. 2 University Medical Center Utrecht, Utrecht, The Netherlands
  3. 3 Meander Medical Center, Amersfoort, The Netherlands
  1. Correspondence to Klaas Koop, Meander Medical Center, Postbus 1502, Amersfoort 3800 BM, The Netherlands; klaaskoop{at}

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A 2-year-old girl presented with recurrent episodes of pharyngitis and a perineal rash. During the first episode, a course of antibiotics resulted in a quick resolution of symptoms. Yet a few days later, her symptoms had recurred and she was referred to our clinic. She was febrile, her lips were red and fissured (figure 1A), the tonsils were enlarged and red, she had a pronounced perineal rash (figure 1 …

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  • Contributors All authors were involved in the clinical management of the patient. JJ had end-responsibility for the management of the patient. REB and PR wrote the initial draft of the manuscript, all other authors contributed to the final version of the manuscript. All authors have approved the final version of the manuscript.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.