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June 2016

Rumpel-Leede Phenomenon Associated With Tourniquet-like Forces of Baby Carriers in Otherwise Healthy InfantsBaby Carrier Purpura

Author Affiliations
  • 1Albert Einstein College of Medicine, Bronx, New York
  • 2Division of Pediatric and Adolescent Dermatology, Rady Children’s Hospital, San Diego, California
  • 3University of California, San Diego, La Jolla
  • 4DermOne LLC, West Conshohocken, Pennsylvania
JAMA Dermatol. 2016;152(6):728-730. doi:10.1001/jamadermatol.2015.6270

Acute-onset, localized petechiae and purpura of the lower extremities occurred in 3 otherwise healthy infants following recent exposure to baby carriers. This case series identifies tourniquet-like forces associated with baby carriers as a mechanical cause of the Rumpel-Leede phenomenon.

The index patient’s father—a pediatric dermatologist—had taken his infant son on a 2-hour hike using a “legs out,” forward-facing baby carrier. At the hike’s conclusion, the cloth material of the baby carrier was noted to have cinched tight around the infant’s lower extremities. Almost immediately after release of tension on the cloth material, a showering of petechiae and purpura was observed on the infant’s legs, with a sharp, symmetric cutoff at the proximal thighs (Figure). Pulses were normal, and edema was absent. The patient remained afebrile, and the lesions spontaneously resolved over several days.

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