Acute hemorrhagic edema of infancy

An 11-month-old boy initially presented to an outside hospital with fever, rhinorrhea, swelling, and papular lesions involving the left foot. He was diagnosed with necrotizing fasciitis and he subsequently underwent debridement of the lower left leg. Tissue cultures were submitted and were negative. Histopathological examination revealed a subcutaneous leukocytoclastic vasculitis. The patient was then transferred to the University of California Davis Medical Center at which time he was noted to have erythematous nontender annular and targetoid patches and plaques with purpuric centers; the lesions were scattered over the legs, right foot, flanks, and pinnae. The clinical and histopathological findings supported a diagnosis of acute hemorrhagic edema of infancy. Supportive care was maintained and the lesions and associated edema resolved. Acute hemorrhagic edema of infancy is a form of leukocytoclastic vasculitis that, despite a rapid and dramatic onset, has a benign prognosis.