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In 1996, Manders described a recurrent perineal erythema in two young men that erupted regularly within 1 to 2 days of the onset of acute pharyngitis (see Arch Dermatol 1996; 132:57). Mucosal changes and acral erythema with desquamation accompanied these symptoms. Throat cultures yielded toxin-producing Staphylococcus aureus in one patient and toxin-producing Streptococcus pyogenes in the other. This disorder, named recurrent toxin-mediated perineal erythema (RTMPE), was added to the list of superantigen toxin-mediated syndromes, which includes toxic shock syndrome and streptococcal toxic shock-like syndrome. Kawasaki disease (KD) may be a superantigen toxin-mediated disease, as well.
Now, researchers describe perineal erythema in 11 childre…