ACUTE HEMORRHAGIC EDEMA OF INFANCY

Acute Hemorrhagic Edema of Infancy


Acute hemorrhagic edema of infancy is an uncommon form of cutaneous leukocytoclastic vasculitis that occurs in children younger than 3 years of age. Many consider it to be the infantile variant of Henoch-Schonlein purpura but there are many key differences (see table below). Precipitating factors include an upper respiratory tract infection, medication, and vaccination.

Clinical

Symmetric, purpuric, targetoid lesions occur on the face and extremities. Facial purpura is more common than in Henoch-Schonlein purpura, probably because standing and gravitational effects are not as much a factor in localization. Internal involvement is rare. Average age of onset is 11 months. In the majority of cases, the onset is preceded by an illness for which antibiotics are often given.

Acute hemorrhagic edema of infancy vs Henoch-Schonlein purpura

AHEI HSP
Age Less than 2 years > 2 years
Morphology Cockade purpura Palpable purpura
Distribution Face, ears, extremities Lower extremities, buttocks
Systemic Involvement Rare, transient Joint, GI and Renal Risk of long-term dz
Skin Biopsy +IgA <30% >70-90%
Clinical Course Resolves in 1-3 weeks Many resolve in 2-4 wks but may persist longer Recurrences in 20-30%

Treatment

No specific treatment is needed. Spontaneous resolution may be expected within 1-3 weeks.

References

Indian J Dermatol 2015;60:624-5

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