A Review of Infantile Acrodynia ('Pink Disease')

Selter (1903, 1927), who first described the syndrome of infantile acrodynia clearly, had by 1927 recognized that the apparently incoherent multitude of functional disturbances could be satisfactorily explained as due to autonomic dysfunction, and used the term vegetative neurosis. A groping towards causation has only been possible by a process of exclusion. The concept of diet deficiency, for example, has been abandoned, attractive as it seemed at one time, partly because the disease, whether in symptoms or pathology, resembles no known deficiency disease in man, and partly because it is found very frequently in conditions which seem to preclude malnutrition. The limits of age within which authentic cases have been reported are from the third week (Wyllie and Stern, 1931) to the fourth year; above this age there are probably a few cases which would be recognized by paediatricians or neurologists as falling within the descriptive category, but none of the cases described in later childhood reproduce the typical picture of infantile acrodynia, and the very rare cases reported in adults (White, 1926) rest on insecure evidence. This is not to say that it is impossible for the disease to occur at other ages with a rather different appearance; indeed it is unlikely that a disease which appears not to have its origins in prenatal life or birth itself should be confined to the first four years. The symptoms of acrodynia as they appear to the physician may be grouped roughly as follows: