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[Management of chicken pox purpura fulminans: a pediatric case report]

S Domergue1, M Rodiere, M Bigorre

  • 1Service de chirurgie maxillofaciale et de chirurgie plastique infantile, hôpital Lapeyronie, avenue du doyen-Gaston-Giraud, 34000 Montpellier, France. domergue.sophie@caramail.com

Annales De Chirurgie Plastique Et Esthetique
|March 1, 2006
PubMed

Insights

A 4-year-old girl with chicken-pox purpura fulminans experienced rapid skin necrosis. Multidisciplinary management including anticoagulation and skin grafting led to a good long-term outcome.

Area of Science:

  • Pediatrics
  • Dermatology
  • Hematology

Background:

  • Purpura fulminans is a rare, severe thrombotic disorder often associated with infections.
  • Chickenpox (varicella) can, in rare cases, trigger purpura fulminans, leading to extensive skin necrosis.

Observation:

  • A 4-year-old girl presented with purpura fulminans 5 days after the onset of chickenpox.
  • Lesions rapidly evolved into cutaneous and subcutaneous necrosis on her thighs and calf.
  • Medical management included fresh plasma, blood, antithrombin III, fibrin, heparin, and activated protein C.

Findings:

  • Surgical debridement of necrotic areas and subsequent skin grafting from the scalp were performed 5 weeks after presentation.
  • The patient experienced rapid healing and good functional and aesthetic outcomes at a 3-year follow-up.

Implications:

  • This case highlights the importance of a multidisciplinary approach in managing chicken-pox-associated purpura fulminans.
  • Early medical intervention combined with delayed surgical management can lead to favorable outcomes.
  • The scalp is a viable donor site for skin grafting in pediatric cases due to its abundant skin and minimal aesthetic impact.

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