Acute Hemorrhagic Edema of Infancy With Targetoid Purpura and Mild Mucosal Involvement

TL;DR

This paper presents a case of a rare skin condition in a young child, highlighting its unique features and successful conservative management.

Contribution

The case emphasizes the importance of recognizing mild mucosal involvement in AHEI for accurate diagnosis.

Findings

The patient exhibited targetoid purpura and mild mucosal involvement without systemic complications.

Conservative management led to complete resolution of mucosal lesions and improvement in skin symptoms.

The case aids in distinguishing AHEI from other similar skin conditions.

Abstract

Acute hemorrhagic edema of infancy (AHEI) is a rare leukocytoclastic vasculitis characterized by the abrupt onset of purpuric and targetoid lesions with edema in young children. A 13-month-old previously healthy girl presented with a rapidly progressive rash involving the face, trunk, and extremities following a brief febrile illness. Cutaneous examination revealed sharply demarcated purpuric papules and plaques with targetoid configuration and central duskiness, accompanied by mild lip erosions and shallow oral ulceration. The patient remained systemically well, and laboratory investigations were reassuring, with no evidence of renal, gastrointestinal, or hematologic involvement. Based on the characteristic clinical presentation and benign course, a diagnosis of AHEI was made, and a skin biopsy was not pursued. The patient was managed conservatively with supportive care. At one-week follow-up, the mucosal lesions had resolved completely, and the purpuric eruption had markedly improved. This case illustrates a classic presentation of AHEI with mild mucosal involvement and highlights key clinical features that aid in distinguishing it from other targetoid eruptions, allowing avoidance of unnecessary investigations and reassurance of caregivers.

Figures