An 18-month-old girl presents with pink, sweaty palms and soles, marked irritability, photophobia, excessive salivation, and desquamation of the hands and feet. Her mother had been giving her a teething powder bought abroad. The most likely diagnosis is:

• A Kawasaki disease
• B Arsenical keratosis
• C Acrodynia (pink disease) due to mercury poisoning ✓
• D Scarlet fever

Explanation

Acrodynia, historically called Feer's or Swift's disease, is chronic elemental or inorganic mercury poisoning of infants and children, classically linked to teething powders containing calomel. It features erythema and sweating of hands and feet, pain out of proportion to findings, photophobia, irritability, and desquamation. Kawasaki disease shares some mucocutaneous features but lacks the profound sweating and photophobia combination and is not toxin related.

Reference: Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.