Acute hemorrhagic edema of young children: open questions and perspectives

Childhood vasculitis is a challenging group of conditions that are often multisystem in nature and may require integrated care from multiple pediatric subspecialists, including cardiologists, dermatologists, gastroenterologists, nephrologists, neurologists, and rheumatologists. Apart from Henoch Schönlein syndrome, recently renamed immunoglobulin A vasculitis, and Kawasaki disease, which are reltively common, there are a number of important but comparatively rare vasculitides affecting children [1-4]. Acute hemorrhagic edema of young children [5-8] is a skin limited nongranulomatous leukocytoclastic small-vessel vasculitis, which usually develops in previously healthy subjects after a simple, mostly viral, febrile illness (more rarely after a vaccination). The condition was initially reported in 1913 by Irving Snow in the United States and in 1936 by Mario Del Carril in Argentina [5,6]. The most comprehensive descriptions, however, were made in Germany before the Second World War by Heinrich Finkelstein (1865–1942) and later by Hubert Seidlmayer (1910–1965). A significant description was also made in 1942 by Marcel Lelong (1892-1973) in France [5,6]. Acute hemorrhagic edema has been known with a variety of synonyms: acute hemorrhagic edema of young children (or infancy), cockade (or iris-like) purpura and edema of young children, Henoch–Schönlein syndrome of early childhood, Finkelstein-Seidlmayer syndrome, Finkelstein syndrome and Seidlmayer syndrome [5,6,8].