DOI: http://dx.doi.org/10.18203/2349-3933.ijam20191172

Role of systemic steroids in acute hemorrhagic edema of infancy: report of two cases

Mohammed S. Alharbi

Abstract


Acute hemorrhagic edema of infancy (AHEI) is an unusual form of leukocytoclastic vasculitis with dramatic distinguishing skin lesions that occurs in infants who age 4 to 24 months old. Clinical presentation at onset requires clinical and, less often, histological evaluation to distinguish it from more serious diseases and other vasculitis. Treatment of AHEI remains controversial; and since it is a self-limiting disease, a conservative approach should be considered first. Although some authors have reported that the use of steroids may be beneficial if started early on, we think their use, based on our presented cases here, may accelerate the healing and improves the color of preexisting skin lesions but does not significantly alter the course of the disease. Authors reported here two clinical Cases of AHEI (Diagnosed based on characteristic skin lesions and confirmed with Histological evaluation) who were treated initially with systemic steroids, besides we reviewed the role of systemic steroids in the treatment of AHEI.


Keywords


Acute, Edema, Hemorrhagic, Infancy, Steroids, Vasculitis

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References


Lernia VDI, Lombardi M, Scocco GL. Infantile Acute Hemorrhagic Edema and Rotavirus infection. Pediatr Dermatol. 2004;21:548-50.

Caksen H, Odabas D, Kösen M, Arslan S, Öner AF, Atas B, et al. Report of eight infants with Acute Infantile Hemorrhagic Edema and review of the literature. J Dermatol. 2002;29:290-5.

Amitai Y, Gillis D, Wasserman D, Kochman RH. Henoch-Schöenlein purpura in infants. Pediatrics. 1993;92:865-67.

Paradisi M, Annessi G, Corrado A. Infantile Acute Hemorrhagic Edema of the skin. Cutis. 2001;68:127-9.

Cabrera RG, Domínguez OF, Perdomo ME, Medina Calvo F, Báez MO. Acute hemorrhagic edema in a nursing infant: a report of 5 cases. An Esp Pediatr. 1998;48:73-5.

Snow IM. Purpura, urticaria, and angioneurotic edema of the hands and feet in a nursing baby. JAMA. 1913;61:18-9.

Fiore E, Rizzi M, Ragazzi M, Vanoni F, Bernasconi M, Bianchetti MG, et al. Acute hemorrhagic edema of young children (cockade purpura and edema): a case series and systematic review. J Amer Acad Dermatol. 2008 Oct 1;59(4):684-95.

Karremann M, Jordan AJ, Bell N, Witsch M, Dürken M. Acute hemorrhagic edema of infancy: report of 4 cases and review of the current literature. Clin Pediatr. 2009;48:323-6.

AlSufyani MA. Acute hemorrhagic edema of infancy: unusual scarring and review of the English language literature. Int J Dermatol. 2009;48:617-22.

Shah D, Goraya JS, Poddar B, Parmar VR. Acute infantile hemorrhagic edema and Henoch-Scho nlein purpura overlap in a child. Pediatr Dermatol. 2002;19:92-3.

Watanabe T, Sato Y. Renal involvement and hypocomplementemia in a patient with acute hemorrhagic edema of infancy. Pediatr Nephrol. 2007;22:1979-81.

Saraclar Y, Tinaztepe K, Adaliolu G, Tuncer A. Acute hemorrhagic edema of infancy (AHEI)- a variant of Henoch-Schonlein purpura or a distinct clinical entity? J Allergy Clin Immunol. 1990;86:473-83.

Paradisi M, Annessi G, Corrado A. Infantile acute hemorrhagic edema of the skin. Cutis. 2001;68:127-9.

Krause I, Lazarov A, Rachmel A, Grunwald MM, Metzker A, Garty BZ, et al. Acute haemorrhagic oedema of infancy, a benign variant of leucocytoclastic vasculitis. Acta Pediatr. 1996;85:114-7.

Goraya J, Kaur S. Acute hemorrhagic edema and Henoch-Schonlein purpura: is IgA the missing link? J Am Acad Dermatol. 2002;47:801.

Fiore E, Rizzi M, Simonetti GD, Garzoni L, Bianchetti MG, Bettinelli A. Acute hemorrhagic edema of young children: a concise narrative review. Eur J Pediatr. 2011;170:1507-11.

Fotis L, Nikorelou S, Lariou MS, Delis D, Stamoyannou L. Acute hemorrhagic edema of infancy: a frightening but benign disease. Clin Pediatr. 2012;51:391-3.

Jindal SR, Kura MM. Acute hemorrhagic edema of infancy- a rare entity. Ind Dermatol Online J. 2013;4:106-8.

Saraclar Y, Tinaztepe K, Adaliolu G, Tuncer A. Acute hemorrhagic edema of infancy (AHEI)- a variant of Henoch-Schonlein purpura or a distinct clinical entity? J Allergy Clin Immunol. 1990;86:473-83.

Goraya J, Kaur S. Acute hemorrhagic edema andHenoch-Schonlein purpura: is IgA the missing link? JAm Acad Dermatol. 2002;47:801.