Edema hemorrágico agudo en un lactante / Acute hemorrhagic edema of infancy

Niña de 20 meses de edad que había presentado la semana previa un cuadro catarral febril, en la que aparecieron placas edematosas, equimótico-purpúricas en las extremidades inferiores de forma simétrica, ni dolorosas a la palpación ni pruriginosas. No había lesiones en la cara y su estado general era bueno. Se realizó el diagnóstico de edema agudo hemorrágico del lactante (EAHL) por el aspecto clínico de las lesiones. Se le realizó un control evolutivo en el centro de salud, sin que requiriera tratamiento específico, y las lesiones desaparecieron completamente en el plazo de 2 semanas. El edema agudo hemorrágico del lactante es una vasculitis leucocitoclástica de pequeños vasos, con unas manifestaciones cutáneas muy llamativas, por el aspecto, la rapidez y la brusquedad de aparición de las lesiones, a pesar de lo cual tiene una evolución benigna, puesto que no hay afectación del estado general. El diagnóstico debe ser clínico y no es preciso instaurar ningún tratamiento (AU)

We present a case of a 20-month baby girl who had shown the previous week a febrile upper respiratory tract infection. During this process edematous plaques appeared, ecchymotic purpuric with symmetrical form on the lower extremities, they did not itch or were painful to touch. There were no lesions on the face and the patient's general medical state was satisfactory. A diagnosis of acute hemorrhagic edema of infancy (AHEI) was made based on the clinical aspect of the lesions. Regular checkups were performed in the clinic to monitor the progress of the condition and without requiring specific treatment the lesions disappeared completely within a period of two weeks. AHEI is a type of cutaneous leukocyteclastic vasculitis of small blood vessels and is striking due to its appearance the speed and abruptness at which the lesions spreads. Despite all it has a benign prognosis given that it does not negatively affect the general medical state of the patient. The diagnosis should be clinical and no treatment is necessary (AU)

Erythema multiforme: a review of twenty cases.

The clinical histories of twenty children hospitalized for erythema multiforme (EM) were reviewed. Three forms of the illness were defined according to clinical criteria: minor (EMm), intermediate (EMt) and major (EMM). Previous infections were associated with the process in 30% of the cases, administration of drugs also in 30%, and a combination of the two factors in 30% of the subjects. No specific etiology was found in two cases (10%). Respiratory tract symptoms and general discomfort preceded the EMM form, and evidence of digestive organ involvement was frequent in the EMm form. Erythrocyte sedimentation rate was usually high. Postinflammatory sequelae occurred in only two cases, and one subject died in the first 24 hours.

[Congenital syphilis and syphilitic mothers. Survey of the past 10 years]. / Sífilis congénita versus de madre luética. Revisión de los últimos 10 años.

Two hundred and sixty-two newborn infants, born to mothers with a positive syphilis serology, have been studied. Twenty-six newborn infants had congenital syphilis and two hundred and thirty-six were considered as newborn infants from syphilitic mothers. This study has demonstrated that the newborn infants with congenital syphilis have been born to mothers with greatest risk factors. Newborn infants with congenital syphilis born to mothers on treatment during the pregnancy had a milder case of congenital syphilis than newborn infants born to mothers without treatment during the pregnancy. A diagnostic test for the treatment in these newborns has been proposed; if the test score is less than 5, we are dealing with a child of a syphilitic mother that does not need treatment and if the test results are higher than 5 we can confirm the diagnosis of congenital syphilis and immediate treatment must be started.