BACKGROUND: Acute hemorrhagic edema of infancy (AHEI) is a leukocytoclastic vasculitis of infants. Even though the cutaneous findings are dramatic in both appearance and rapidity of onset, the prognosis is benign. METHODS: We report on eight patients with AHEI evaluated from the viewpoints of age, sex, history of infection, drug administration or immunization before the onset of skin lesions, laboratory findings, cutaneous findings, cutaneous biopsy and treatment. RESULTS: The ages of the patients, six of whom were male, ranged between 7 and 27 months. Five episodes in our patients occurred in winter. Six patients (75%) had a history of recent infection, drug administration or immunization. All patients had fever, peripheral edema and large, purpuric, annular or targetoid plaques on the face and extremities. Two patients had mucosal involvement (conjunctiva and palatum molle). One patient with severe genital involvement had trunk involvement. Hematologic and immunologic tests were not diagnostic in any patient. Leukocytoclastic vasculitis was demonstrated in four patients for whom a cutaneous biopsy was performed. Complete recovery time ranged between 4 and 7 days. CONCLUSIONS: We believe that AHEI is a benign disorder, despite its dramatic appearance. We want to point out that mucosal and trunk involvement may also occur in AHEI.
BACKGROUND: Acute hemorrhagic edema of infancy (AHEI) is a leukocytoclastic vasculitis of infants. Even though the cutaneous findings are dramatic in both appearance and rapidity of onset, the prognosis is benign. METHODS: We report on eight patients with AHEI evaluated from the viewpoints of age, sex, history of infection, drug administration or immunization before the onset of skin lesions, laboratory findings, cutaneous findings, cutaneous biopsy and treatment. RESULTS: The ages of the patients, six of whom were male, ranged between 7 and 27 months. Five episodes in our patients occurred in winter. Six patients (75%) had a history of recent infection, drug administration or immunization. All patients had fever, peripheral edema and large, purpuric, annular or targetoid plaques on the face and extremities. Two patients had mucosal involvement (conjunctiva and palatum molle). One patient with severe genital involvement had trunk involvement. Hematologic and immunologic tests were not diagnostic in any patient. Leukocytoclastic vasculitis was demonstrated in four patients for whom a cutaneous biopsy was performed. Complete recovery time ranged between 4 and 7 days. CONCLUSIONS: We believe that AHEI is a benign disorder, despite its dramatic appearance. We want to point out that mucosal and trunk involvement may also occur in AHEI.
Authors: Alessandra Ferrarini; Cecilia Benetti; Pietro Camozzi; Alessandro Ostini; Giacomo D Simonetti; Gregorio P Milani; Mario G Bianchetti; Sebastiano A G Lava Journal: Eur J Pediatr Date: 2015-11-25 Impact factor: 3.183