Cutaneous necrotizing vasculitis associated with hepatitis A virus infection

Hepatitis A virus has been recognized as an etiologic factor of cutaneous necrotizing vasculitis in only 2 adult cases. We describe 2-year-old Bedouin girl who developed cutaneous necrotizing vasculitis during the acute phase of hepatitis A infection, The cutaneous punch biopsy from an ecchymotic lesion revealed microscopic findings of a necrotizing vasculitis process involving the superficial and deep blood vessel plexuses. Fibrin thrombi were present in the lumen of a few blood vessels. She was treated with prednisone 2 mg/kg/day, tapered during 5 weeks, Serum liver enzymes returned to the normal range within 6 weeks of the first presenting symptom. A few skin scars were noted in previously necrotic areas. Hepatitis A is one of many viruses that may be an etiologic factor in development of cutaneous necrotizing vasculitis in children.