Too-tight baby carrier can cause Rumpel-Leede phenomenon

By Reuters Staff

A baby carrier that is too tight around the infant's legs can cause Rumpel-Leede phenomenon, according to a case series.

Rumpel-Leede phenomenon, characterized by acute dermal capillary rupture caused by tourniquet-like forces leading to distal petechiae and purpura on release of pressure, has been reported in association with scarlet fever, medications, leukemia, and conditions predisposing to capillary fragility.

In a paper online February 17 in JAMA Dermatology, Dr. Andrew C. Krakowski from DermOne LLC, West Conshohocken, Pennsylvania, and colleagues report three cases of Rumpel-Leede phenomenon in the lower extremities of healthy infants who had recently been exposed to baby carriers.

In the first case, a showering of petechiae and purpura appeared soon after the release of the cloth material that had been cinched around the infant's lower extremities, and the exam was otherwise normal.

None of the infants had an underlying bleeding diathesis, and the lesions resolved completely within several weeks. All three children remained well through follow-up.

Two of the infants had mild transaminitis, suggesting the possibility of a predisposing viral cause.

"Acute onset of petechiae and purpura requires careful investigation to exclude serious underlying causes," the authors conclude.

"At a minimum," they add, "direct observation and screening laboratory tests (e.g., complete blood cell count, comprehensive metabolic panel, coagulation profile) may be warranted. In the specific setting of a supporting history and physical examination with well-demarcated localized findings, however, recognition of the Rumpel-Leede phenomenon presenting as 'baby carrier purpura' may help spare infants from unnecessary, costly, and invasive evaluations and treatments."

Dr. Krakowski did not respond to a request for comment by press time.

SOURCE: bit.ly/1XM5laX

JAMA Dermatol 2016.

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