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Infant with a rapidly progressing rash
  1. Rachelle Hancock,
  2. Ilene Rothman,
  3. Mary Kate Mannix and
  4. Shamim Islam
  1. Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
  1. Correspondence to Ms Rachelle Hancock; rhancock{at}


An infant presented to the emergency department with sudden onset of rapidly progressing erythematous macules and distal oedema. The rash was striking in appearance, covering most of the body, which raised concern for pressing infectious (eg, meningococcaemia) and other serious aetiologies. Nevertheless, the infant remained playful and was overall stable and posed a diagnostic and management dilemma. After an extensive workup and multispecialty consultations, the patient was eventually diagnosed with acute haemorrhagic oedema of infancy, a benign leucocytoclastic vasculitis. The patient received no treatment and resolution of the rash occurred within 7 days of onset. Recognition of this condition and its benign nature can spare patients from an extensive workup and reduce anxiety for both family members and healthcare providers.

  • paediatrics
  • emergency medicine
  • dermatology
  • immunology

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  • Contributors RH and SI contributed to the conception of the manuscript. All authors contributed to the acquisition and analysis of information. RH prepared the manuscript draft, and SI, IR and MKM provided critical revisions. All authors participated in peer review edits, approved the final manuscript and agree to be accountable for all aspects of the work ensuring accuracy and integrity.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.