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.
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.
|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%|
No specific treatment is needed. Spontaneous resolution may be expected within 1-3 weeks.
Indian J Dermatol 2015;60:624-5
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