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Fig. 15.2 Acute hemorrhagic edema of a young child demonstrating hemorrhagic indurated plaques of the head. As seen here, the ears and cheeks are frequently involved. (Courtesy of the Joanna Burch Collection.) |
Acute hemorrhagic edema of infancy, which also called “cockade purpura,” is also an IgA-mediated immune complex leukocytoclastic vasculitis that affects small cutaneous vessels. This variant almost always affects young children (median age is 11 months), and like Henoch-Schönlein purpura, it is usually associated with a preexisting upper respiratory infection. It differs in that the primary cutaneous clinical lesions are typically indurated, edematous plaques with variable hemorrhage that are less likely to ulcerate. The lesions frequently affect the head and neck region and extremities (Fig. 15-2). The children typically do not demonstrate significant involvement of the gastrointestinal tract, joints or kidneys and do not develop permanent sequelae.
Fiore E, Rizzi M, Ragazzi M, et al: Acute hemorrhagic edema of young children (cockade purpura and edema): a case series and systematic review,
J Am Acad Dermatol 59:684–695, 2008.