A 4-year-old child presents with pink, maculopapular, sweating rash over the hands and feet, irritability, photophobia, profuse sweating, and peeling of palms and soles. The family runs a thermometer-repair workshop at home. What is the most likely diagnosis?

• A Kawasaki disease
• B Acrodynia due to chronic mercury exposure ✓
• C Lead encephalopathy
• D Chronic thallium poisoning

Explanation

Acrodynia, or pink disease, is the classic presentation of chronic elemental or inorganic mercury poisoning in young children, caused by hypersensitivity to mercury. It features pink painful extremities, sweating, photophobia, irritability, and desquamation of palms and soles. Kawasaki disease also affects young children but presents with fever, conjunctivitis, mucositis, and cervical lymphadenopathy rather than a household mercury source, which rules out the best distractor A.

Reference: Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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