An Impressive, Sudden, and Purpuric Eruption

An afebrile 18-month-old boy, previously healthy, presented with an asymptomatic purpuric eruption for 1 day. Physical examination showed large, purpuric, medallion-shaped blanching patches on the cheeks and auricles, and multiple erythematous, targetoid, and coalescing patches in limbs (Figure, A-D). Apart from a slight rhinitis, the rest of clinical and routine laboratory examinations were unremarkable, including coagulation tests. C-reactive protein was slight elevated (1.5 mg/dL). A diagnosis of acute hemorrhagic edema of infancy was made.

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