A benign cause of a striking purpuric rash in a 24-month-old previously healthy boy: a case report

Purpuric rashes with edema in infants are treated as clinical red flags, requiring urgent exclusion of life-threatening causes such as sepsis or meningococcemia, while vasculitides such as immunoglobulin A (IgA) vasculitis remain part of the broader differential work-up. Although more than 400 cases of Finkelstein-Seidlmayer vasculitis (also known as acute hemorrhagic edema of infancy) have been documented, recent systematic reviews show that misconceptions persist regarding fever as a diagnostic criterion, medication-related triggers, and the need for invasive evaluation. Contemporary evidence now describes the diagnostic hallmark as purpura and non-pitting edema in a well-appearing infant, with fever present in only a subset of cases. This case contributes additional value by illustrating centrifugal progression with genital involvement and full recovery without pharmacologic therapy, supporting quaternary prevention.