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Acute haemorrhagic oedema of infancy, also termed cockade purpura with edema or Finkelstein-Seidlmayer disease, is a rather uncommon small-vessel leukocytoclastic vasculitis. It characteristically affects children 4 weeks to 23 months of age, is skin-limited, spontaneously recovers within 3 weeks, and does not recur. O'Connor C et al . recently documented the distinctive features of acute haemorrhagic oedema in a 23-day-old male infant with fever, rhinorrhoea, conjunctivitis and cough. The authors concluded that acute haemorrhagic oedema has never previously been reported in neonates, with the exception of a female newborn infant noted to have this vasculitis at birth .
Stimulated by the fascinating report by O'Connor C et al. , we analyzed the data contained in the Acute Hemorrhagic Edema BIbliographic Database AHEBID, which includes all articles on acute haemorrhagic oedema. In the mentioned database, we found 6 further cases (4 males and 2 female patient) of this vasculitis in subjects less than 4 weeks of age, including 4 familial cases [3-5].
It is therefore concluded that acute haemorrhagic oedema has been so far documented in a total of 8 patients (5 males and 3 female patient) less less than 4 weeks of age. In this age group, this vasculitis is uncommon but not exceptional and may affect 2 or more members of the same family.
1. O’Connor C, Bux D, O’Connell M. Acute haemorrhagic oedema of infancy: first report...
1. O’Connor C, Bux D, O’Connell M. Acute haemorrhagic oedema of infancy: first report of a rare small vessel vasculitis in the neonatal period. Arch Dis Child 2020: Epub ahead of print. doi:10.1136/archdischild-2020-319739.
2. Cunningham BB, Caro WA, Eramo LR. Neonatal acute hemorrhagic edema of childhood: case report and review of the English-language literature. Pediatr Dermatol 1996;13:39-44.
3. Ballona R. Pápulas purpúricas en récien nacido. Dermatol Peru 2002;12:231-3.
4. Checa Rodríguez R, Carabaño Aguado I, Álvarez Fernández B. Edema agudo hemorrágico en un neonato. Pediatr Aten Primaria 2015;17:151-3.
5. Ostini A, Ramelli GP, Mainetti C, Bianchetti MG, Ferrarini A. Recurrent Finkelstein-Seidlmayer disease in four first-degree relatives. Acta Derm Venereol 2015;95:622-3.