Gabriel Bronz1,2, Pietro O Rinoldi1, Camilla Lavagno1, Mario G Bianchetti1,2, Sebastiano A G Lava3, Federica Vanoni1, Gregorio P Milani4,5, Isabella Terrani6, Alessandra Ferrarini7. 1. Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland. 2. Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland. 3. Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland. 4. Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. 5. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. 6. Department of Dermatology, Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, Lugano, Switzerland. 7. Service of Medical Genetics, Ospedale Italiano di Lugano, Lugano, Switzerland.
Abstract
BACKGROUND: Acute hemorrhagic edema is a skin-limited small-vessel leukocytoclastic vasculitis, which affects infants 4 weeks to 2 years of age and remits within 3 weeks. The diagnosis is made clinically in not-ill appearing children with acute onset of raised annular or nummular eruptions and edema. In this vasculitis, type, distribution, and evolution of the rash have never been systemically investigated. To address this issue, we employed the data contained in the Acute Hemorrhagic Edema Bibliographic Database, which incorporates all reports on acute hemorrhagic edema. SUMMARY: Key features of rash were documented in 383 children. Annular eruptions in a strict sense, usually targetoid, were reported in 375 (98%) cases (many children also presented polycyclic or arciform eruptions). Nummular eruptions were also very common (n = 358; 93%). Purpuric eruptions and ecchymoses were reported in the vast majority of cases. Macules and wheals were described in a minority of cases. Edema, detected in all cases, was mostly painful, indurated and nonpitting. The following regions were affected, in decreasing order, by annular or nummular eruptions: legs, feet, face, arms, ears, trunk, and genitals. With the exception of feet, which were very often affected, the same distribution was reported for edema. The initial eruption was often a wheal or a macule that evolved into a nummular or an annular eruption. Nummular eruptions successively evolved into annular ones. KEY MESSAGE: This study carefully characterizes type, distribution, and evolution of skin eruption in acute hemorrhagic edema. The data help physicians to rapidly and noninvasively make the clinical diagnosis of this vasculitis.
BACKGROUND: Acute hemorrhagic edema is a skin-limited small-vessel leukocytoclastic vasculitis, which affects infants 4 weeks to 2 years of age and remits within 3 weeks. The diagnosis is made clinically in not-ill appearing children with acute onset of raised annular or nummular eruptions and edema. In this vasculitis, type, distribution, and evolution of the rash have never been systemically investigated. To address this issue, we employed the data contained in the Acute Hemorrhagic Edema Bibliographic Database, which incorporates all reports on acute hemorrhagic edema. SUMMARY: Key features of rash were documented in 383 children. Annular eruptions in a strict sense, usually targetoid, were reported in 375 (98%) cases (many children also presented polycyclic or arciform eruptions). Nummular eruptions were also very common (n = 358; 93%). Purpuric eruptions and ecchymoses were reported in the vast majority of cases. Macules and wheals were described in a minority of cases. Edema, detected in all cases, was mostly painful, indurated and nonpitting. The following regions were affected, in decreasing order, by annular or nummular eruptions: legs, feet, face, arms, ears, trunk, and genitals. With the exception of feet, which were very often affected, the same distribution was reported for edema. The initial eruption was often a wheal or a macule that evolved into a nummular or an annular eruption. Nummular eruptions successively evolved into annular ones. KEY MESSAGE: This study carefully characterizes type, distribution, and evolution of skin eruption in acute hemorrhagic edema. The data help physicians to rapidly and noninvasively make the clinical diagnosis of this vasculitis.
Authors: Elizabeth M Marchionne; Timothy H McCalmont; Laura B Pincus; Philip E LeBoit; Lindy P Fox Journal: J Am Acad Dermatol Date: 2019-06-01 Impact factor: 11.527
Authors: Sebastiano A G Lava; Gregorio P Milani; Emilio F Fossali; Giacomo D Simonetti; Carlo Agostoni; Mario G Bianchetti Journal: Clin Rev Allergy Immunol Date: 2017-12 Impact factor: 10.817
Authors: Gabriel Bronz; Danilo Consolascio; Mario G Bianchetti; Pietro O Rinoldi; Céline Betti; Sebastiano A G Lava; Gregorio P Milani Journal: Children (Basel) Date: 2022-02-15