Rumpel‐Leede Phenomenon—An alarming rash with benign etiology in 4 healthy infants

Abstract

The Rumpel‐Leede phenomenon (RLP) is a rare clinical presentation and in some cases shown to be related to serious systemic conditions. In children, it has been described in association with idiopathic thrombocytopenic purpura and Henoch‐Schönlein purpura. We present a series of pediatric cases of RLP with mechanical etiologies that had a benign course. We propose minimal investigations for pediatric RLP cases who are systemically well and have a clear suggestive history of a mechanical cause.

Rumpel-Leede phenomenon following radial artery catheterisation

“…Another cause that has been reported is tightly fitting sling-type baby carriers or tightly fitting undergarments or diapers in children. These result in tourniquet-like forces, resulting in petechiae formation most commonly in the lower extremities of these children, with a sharp demarcation noted where the child’s limbs were encompassed by either the sling or the undergarment [ 10 ] . A majority of these children do not have underlying vascular or platelet dysfunction, but the relative fragility of children’s capillaries when compared to adults is the reason for its occurrence in this age group [ 10 ] .…”

“…The Rumpel-Leede phenomenon can raise great concern on the initial examination, especially if the examiner is unfamiliar with the pathology. However, it is important to know that the condition is benign in nature, and commonly resolves with only supportive care within one to two weeks from the initial insult [ 2 , 3 , 10 ] . Given the benign nature of the phenomenon, it is possible that the phenomenon often goes unreported, as patients are normally asymptomatic.…”

“…These result in tourniquet-like forces, resulting in petechiae formation most commonly in the lower extremities of these children, with a sharp demarcation noted where the child's limbs were encompassed by either the sling or the undergarment [10] . A majority of these children do not have underlying vascular or platelet dysfunction, but the relative fragility of children's capillaries when compared to adults is the reason for its occurrence in this age group [10] . Interestingly, only five cases of this phenomenon following radial artery catheterisation have been reported [3][4][5][6][7] .…”

Rumpel-Leede Phenomenon Associated with Pneumatic Compression: A Case Report

“…[15][16][17][18][19] Others included the tourniquet, 8 radial arterial wristband, 12 peritoneal insufflation during laparoscopic abdominal surgery, 13 knee stocking, 21 cloth material, 22 and car seat. 23 Regarding comorbidities, diabetes mellitus, hypertension, and thrombocytopenia are frequently reported. 24 All cases showed spontaneously improved after discontinuing the causative device, and there were no long-term sequelae.…”