Acute hemorrhagic edema of infancy in a 6 week old

Objectives: Uncommon presentations of common diseases present a challenge in recognizing the correct diagnosis. Beside uncommon symptoms, uncommon age of onset challenges the pattern recognition abilities of clinicians. Method(s): Here we present a 6 week old boy with acute haemorrhagic edema of infancy in association with COVID-19. The otherwise healthy term born infant presented in our clinic with fever, mild respiratory symptoms and a rash. After establishing a sufficient saturation of oxygen, also during sleep, the infant was discharged. Result(s): Complete resolution of the rash was within days after. On admittance 60 mg prednisolone rectal was applied by the emergency night shift staff also to stabilize a slight wheeze due to COVID-19 but other than that no therapy was needed. Discussion(s): Reviewing the literature the benign nature of this leucocytoclastic vasculitis was commonly reported as well as the common onset during late infancy (about 8 to 23 months). Very few reports target the age group outside this age brackets. Nonetheless it is important to think outside the box when examining a patient in emergency paediatric derm.atology.

Exploring use of a connected Internet-Of-Things system (A4A+) with CE-marked devices to support asthma selfmanagement? A mixed method study

Background: In the COVID pandemic, patients have had to rely on remote consultations to help them to live with their condition. Aim(s): We aimed to explore how a connected system (A4A+) linking smart devices (inhaler/watch/peak flow meter) could support asthma self-management. Method(s): The A4A+ system collected data from smart devices that could be shared with practices in a pdf attached to patients' electronic health records. We recruited 10 patients via social media, observed their usage of the system over a month, and undertook baseline and exit interviews. We also interviewed 3 GPs and an asthma nurse for their views on the report format. Thematic analysis used the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Result(s): 7517 self-management data-points (asthma symptoms, PEFR, inhaler usage, exercise intensity, heart rate, sleeping pattern, body/air temperature) were collected from 10 patients though recording reduced over the month. Most patients chose to monitor their reliever inhaler rather than the preventer. Patients felt 'positive', found it 'easy' to use the system and chose to use devices they thought were "accurate". Monitoring adjustments to medication, having asthma (or COVID) symptoms triggered and motivated them to adopt the system. Clinicians wanted an overall asthma score/status and reliever usage on the report. Conclusion(s): A connected system could enable flexible digital approaches to care by providing on-going selfmanagement data to support remote consultation. However, providing users with confidence in the 'accuracy' of systems is needed to maintain patients' motivation to use the system.