Vascular reactions in children
Section snippets
Urticaria
It has been estimated that 10–20% of the general population experiences an episode of urticaria during their lifetime.1 Urticaria is a common disease of childhood, and the incidence in children is reported to range between 2.4% and 8.3%.2 Chronic urticaria, defined arbitrarily as lesions present for longer than 6 weeks, develops in a variable proportion of patients ranging, from 5% to 30%. Between 42% and 50% of children with chronic urticaria continue to have symptoms for > 1 year. Within the
Erythema multiforme
The clinical spectrum of erythema multiforme (EM) includes two different presentations. The mild, mainly cutaneous process, originally described by Von Hebra, is known as EM minor, and a more serious mucocutaneous disease described by Stevens and Johnson is known as EM major.16
Stevens-Johnson syndrome (erythema mutliforme major)—toxic epidermal necrolysis
There is growing evidence that Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) constitute a spectrum of disease process distinct from erythema multiforme minor.28 SJS is a serious mucocutaneous illness in which lesions involving at least two mucosal sites, in addition to skin lesions that evolve into bullae and extensive areas of epidermal necrosis and separation, develop. SJS occurs at any age, with the main peak in the second decade and a smaller peak in the fifth decade.16
Henoch-Schönlein (anaphylactoid) purpura
Henoch-Shönlein purpura (HSP) is a form of leukocytoclastic vasculitis characterized by palpable, purpuric skin lesions, arthritis, abdominal pain, and glomerulonephritis. It is the most common form of vasculitis occurring in childhood, mainly 3–10 years of age. It represents an immunological response triggered by a multitude of drugs and infectious agents.36
Acute hemorrhagic edema of infancy
Acute hemorrhagic edema of infancy is an acute, leukocytoclastic vasculitis occurring in infants. It has some common clinical features with HSP and is considered by some authors to be a variant of that syndrome.46 Yet others regard it as a distinct clinical entity.47
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Skin rashes in children treated with commonly used drugs: Do they result from drug hypersensitivity and which work-up should be performed?
2013, Revue Francaise d'AllergologieClinical case: About a Stevens-Johnson syndrome in a child
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2010, Revue Francaise d'AllergologieAllergy and pseudoallergy to drugs and biological substances in children
2007, Revue Francaise d'Allergologie et d'Immunologie CliniqueErythema Multiforme
2007, Comprehensive Pediatric Hospital MedicineLife-threatening purpura and vasculitis
2005, Clinics in Dermatology