Maculopapular rash in the convalescent phase of Kawasaki disease: case series and literature review

Intravenous immunoglobulin (IVIG) is currently the standard treatment for Kawasaki disease (KD). Although IVIG therapy is generally well tolerated, several minor adverse reactions have been reported. We report a patient with KD treated with IVIG, who developed a cutaneous reaction in the convalescent phase (approximately 10 days after therapy). We identified seven additional KD cases with a similar presentation, accounting for 9.3 % of KD patients at our hospital. We performed a literature review and found that a maculopapular rash could be observed approximately 10 days after IVIG treatment, in patients with and those without KD. Conclusion: Maculopapular rash can occur in nearly 10 % of IVIG-treated children with KD in our cohort, approximately 10 days after treatment. A delayed-onset adverse event of IVIG could be a causative etiology of this unrecognized eruption.