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November 1995

Picture of the Month

Author Affiliations

From the Divisions of Nephrology (Drs Ĉalişkan, Kasapçopur, and Sever) and General Pediatrics (Dr Taşdan), Cerrahpaşa Faculty of Medicine, University of Istanbul, Turkey, and the American Board of Pediatrics, Chapel Hill, NC (Dr Tunnessen).

Arch Pediatr Adolesc Med. 1995;149(11):1267-1268. doi:10.1001/archpedi.1995.02170240085014

TWO GIRLS, 10 months (Figure 1 and Figure 2) and 18 months of age (Figure 3 and Figure 4), had similar large, annular purpuric skin lesions. Both children were febrile and had edema of their extremities.

Denouement and Discussion 

Acute Hemorrhagic Edema of Infancy  Although acute hemorrhagic edema of infancy (AHEI) seems to have been first described by Snow in the United States in 1913,1 it receives rare notice in the American literature, with most cases reported from Europe.1 The English-language literature does not include this disorder as a separate entity.2

CLINICAL APPEARANCE  Acute hemorrhagic edema of infancy is a striking disorder similar in many respoects to Henoch-Schönlein purpura (HSP). It is characterized by the sudden appearance of annular and sometimes targetlike purpuric lesions limited almost entirely to the face and extremities, often accompanied by edema and fever. The lesions may begin as urticarial plaques that may enlarge up

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