Acute hemorrhagic edema of young children: a concise narrative review

Acute hemorrhagic edema of young children is an uncommon but likely underestimated cutaneous leukocytoclastic vasculitis. The condition typically affects infants 6-24 months of age with a history of recent respiratory illness with or without course of antibiotics. The diagnosis is made in children, mostly nontoxic in appearance, presenting with nonpruritic, large, round, red to purpuric plaques predominantly over the cheeks, ears, and extremities, with relative sparing of the trunk, often with a target-like appearance, and edema of the distal extremities, ears, and face that is mostly non-pitting, indurative, and tender. In boys, the lesions sometimes involve the scrotum and, more rarely, the penis. Fever, typically of low grade, is often present. Involvement of body systems other than skin is uncommon, and spontaneous recovery usually occurs within 6-21 days without sequelae. In this condition, laboratory tests are non-contributory: total blood cell count is often normal, although leukocytosis and thrombocytosis are sometimes found, clotting studies are normal, erythrocyte sedimentation rate and C-reactive protein test are normal or slightly elevated, complement level is normal, autoantibodies are absent, and urinalysis is usually normal. Experienced physicians rapidly consider the possible diagnosis of acute hemorrhagic edema when presented with a nontoxic young child having large targetoid purpuric lesions and indurative swelling, which is non-pitting in character, and make the diagnosis either on the basis of clinical findings alone or supported by a skin biopsy study.

Writing the Unspeakable: an Ethical Approach to a Traumatized Narrative

This project uses the works of contemporary author Tim O’Brien, whose fiction often performs the trauma of the Vietnam War, to explore new ways of encountering the traumatized text. Informed by Emmanuel Levinas’s ethics of the face, and Sigmund Freud’s and Dominick LaCapra’s work on the narratology of the melancholic and the mourner, I consider the different ways we respond to the suffering Other and explore the paradox that through reading a traumatized narrative empathically we may come face-toface, as it were, with the suffering Other. If this is indeed the case, I reason, then the obligations that are due to the Other are also due to the text itself.