Authors: Elisabetta Fiore Mattia Rizzi Giacomo D Simonetti Luca Garzoni Mario G Bianchetti Alberto Bettinelli
Publish Date: 2011/06/15
Volume: 170, Issue: 12, Pages: 1507-1511
Abstract
Acute hemorrhagic edema of young children is an uncommon but likely underestimated cutaneous leukocytoclastic vasculitis The condition typically affects infants 6–24 months of age with a history of recent respiratory illness with or without course of antibiotics The diagnosis is made in children mostly nontoxic in appearance presenting with nonpruritic large round red to purpuric plaques predominantly over the cheeks ears and extremities with relative sparing of the trunk often with a targetlike appearance and edema of the distal extremities ears and face that is mostly nonpitting indurative and tender In boys the lesions sometimes involve the scrotum and more rarely the penis Fever typically of low grade is often present Involvement of body systems other than skin is uncommon and spontaneous recovery usually occurs within 6–21 days without sequelae In this condition laboratory tests are noncontributory total blood cell count is often normal although leukocytosis and thrombocytosis are sometimes found clotting studies are normal erythrocyte sedimentation rate and Creactive protein test are normal or slightly elevated complement level is normal autoantibodies are absent and urinalysis is usually normal Experienced physicians rapidly consider the possible diagnosis of acute hemorrhagic edema when presented with a nontoxic young child having large targetoid purpuric lesions and indurative swelling which is nonpitting in character and make the diagnosis either on the basis of clinical findings alone or supported by a skin biopsy study
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