Asymmetric Periflexural Exanthem of Childhood Medication

Updated: May 14, 2018
  • Author: Patricia T Ting, MD, MSc, FRCPC, LMCC(Canada); Chief Editor: Dirk M Elston, MD  more...
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Medication Summary

The management of asymmetric periflexural exanthem of childhood typically does not require the use of prescription medications. Low-potency topical steroids such as hydrocortisone 0.5-1% may be used to control inflammation although it usually offers marginal benefit. Hydroxyzine may also be used if the lesions are pruritic and appear disruptive to daily functioning and interfere with normal sleep patterns.


H1-receptor antagonist antihistamines

Class Summary

These agents prevent the histamine response in sensory nerve endings and blood vessels but are not effective at reversing it. They competitively inhibit the binding of histamine at the H1 receptor. Histamine is responsible for mediating wheal and flare reactions, smooth muscle contraction, bronchial constriction, mucus secretion, edema, CNS depression, hypotension, and cardiac arrhythmias.

Hydroxyzine hydrochloride (Vistaril, Atarax, Vistazine)

Hydroxyzine hydrochloride antagonizes H1 receptors in the periphery. It may also suppress histamine activity in subcortical region of the CNS.


Topical anti-inflammatory agents

Class Summary

These agents provide relief of inflammatory eczematous lesions.

Hydrocortisone - topical (LactiCare-HC, Cortaid, Cortate)

Hydrocortisone is a low-potency topical corticosteroid with anti-inflammatory activity, as well as mineralocorticoid and glucocorticoid properties. It decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and reversing increased capillary permeability. Use 1% cream.