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A 3-year-old girl without a clinically significant medical history was seen in the emergency department (ED) with violaceous circular lesions on her extremities that were present for 1 day and a 2-day history of cough, rhinorrhea, and low-grade fever. She was treated with ibuprofen and guaifenesin and discharged to home after normal findings on a complete blood cell count. She returned to the ED 6 hours later with enlarging purpuric macules, increasing in number, on her face, ears, and extremities and was referred for a dermatology consult.
Slutsky JB, Lee K, Adams CW, Jones EC, Hayman RT. Acral Petechiae and Purpuric Plaques in a 3-Year-Old Girl—Quiz Case. Arch Dermatol. 2010;146(9):1037–1042. doi:10.1001/archdermatol.2010.217-a
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