Bull's eye dermatoscopy pattern at bacillus Calmette-Guérin inoculation site correlates with systemic involvements in patients with Kawasaki disease

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• 作者：Han-Chi Tseng ; Ji-Chen Ho ; Mindy Ming-Huey Guo ; Mao-Hung Lo ; Kai-Sheng Hsieh ; Wen-Chien Tsai ; Ho-Chang Kuo and Chih-Hung Lee
• 刊名：The Journal of Dermatology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：43
• 期：9
• 页码：1044-1050
• 全文大小：625K
• ISSN：1346-8138

文摘

For the past decades, although the rash at the bacillus Calmette–Guérin (BCG) inoculation site has been recognized as a diagnostic clue in Kawasaki disease, the present study is the first known one attempting to characterize BCG inoculation by dermatoscopy in Kawasaki disease and correlate the grade of BCG reaction with systemic involvement. Thirty-four patients diagnosed with Kawasaki disease by pediatric specialists were enrolled. We performed detailed history taking, laboratory examination, physical examination and dermatoscopy examinations. Based on the BCG reaction pattern by dermatoscopy, we were able to characterize three patterns: (A) Bull's eye pattern in 18 patients; (B) faint homogenous erythema in nine; and (C) central white patch in seven. Patients from group A exhibited the highest elevation of blood aspartate aminotransferase levels (P < 0.05). Notably, three patients from group A had a significantly dilated coronary artery despite i.v. immunoglobulin injection. We concluded that the bull's eye dermatoscopy sign is not only a useful diagnostic clue but also a severity biomarker in patients with Kawasaki disease.