Skin Eruptions in Acute Hemorrhagic Edema of Young Children: Systematic Review of the Literature.


Journal

Dermatology (Basel, Switzerland)
ISSN: 1421-9832
Titre abrégé: Dermatology
Pays: Switzerland
ID NLM: 9203244

Informations de publication

Date de publication:
2022
Historique:
received: 30 01 2021
accepted: 25 07 2021
pubmed: 23 9 2021
medline: 6 5 2022
entrez: 22 9 2021
Statut: ppublish

Résumé

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. 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. 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.

Sections du résumé

BACKGROUND 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 CONCLUSIONS
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 CONCLUSIONS
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.

Identifiants

pubmed: 34551420
pii: 000519009
doi: 10.1159/000519009
pmc: PMC9153327
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

397-403

Informations de copyright

© 2021 The Author(s). Published by S. Karger AG, Basel.

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Auteurs

Gabriel Bronz (G)

Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.
Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.

Pietro O Rinoldi (PO)

Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.

Camilla Lavagno (C)

Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.

Mario G Bianchetti (MG)

Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.
Family Medicine Institute, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.

Sebastiano A G Lava (SAG)

Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.

Federica Vanoni (F)

Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.

Gregorio P Milani (GP)

Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.

Isabella Terrani (I)

Department of Dermatology, Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, Lugano, Switzerland.

Alessandra Ferrarini (A)

Service of Medical Genetics, Ospedale Italiano di Lugano, Lugano, Switzerland.

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Classifications MeSH