Pediatric emergency medicine trisk 3006 3006

targetoid lesions of the trunk and extremities Vesicular or bullous lesions are rare Changes in the extremities are generally the last clinical manifestation of KD to develop Children demonstrate an indurated edema of the dorsum of their hands and feet, and a diffuse erythema of their palms and soles ( Fig 101.13 ) During the convalescent phase of KD, sheet-like desquamation that begins in the periungual region of the hands and feet is characteristic ( Fig 101.14 ) Linear nail creases known as Beau lines are also common late manifestations of KD As a systemic vasculitis, KD may cause a variety of other clinical manifestations Pulmonary involvement may lead to symptoms such as cough and infiltrates, peribronchial cuffing, and pleural effusions on chest radiographs GI signs may range from emesis and diarrhea to findings suggestive of an acute surgical abdomen Neurologic involvement has been reported, including aseptic meningitis, seizures, facial nerve palsies, ataxia, hemiplegia, and severe encephalopathy In general, as with other vasculitides, manifestations of KD may be extremely variable, so clinicians should not exclude the possibility solely on the basis of atypical features FIGURE 101.12 Bilateral, nonexudative conjunctivitis with sparing of the limbus in Kawasaki disease