| • | AKA papular acrodermatitis of childhood |  
 | • | mnemonic = “PAC for gangsters with Hep B” |  
 | • | often caused by Hepatitis B |  
 | • | EBV and enterovirus = the most common cause in USA |  
 | • | labs: Hep B surface antigen, EBV antibodies,  cx from rectal and nasopharyngeal swabs for coxsackievirus |  
   
clinical: 
| • | eruption is distinct;  dense lentil-shaped, flesh colored to slightly erythematous papules |  
 | • | face and extremities, sparing the trunk |  
 | • | child otherwise asymptomatic |  
 | • | self-limited (2 to 6 weeks);  no treatment  |  
  
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