Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome on - Ask a Doctor - service!

I understand your concern and would like to explain that your sister's child clinical symptomatology need to be further investigated: whether his swollen legs and hands are due to a severe allergic reaction or are a consequence of other concomitant medical conditions (right heart failure, renal dysfunction, etc.)

Some times allergic reactions may trigger coagulation cascade, leading to blood clotting and thrombosis; in such case anti-coagulation may be necessary at least temporarily. In addition, coagulation function and other important components (underlying coagulation factors, complete blood count, liver function) should be monitored.

It is important also to review his cardio-pulmonary function by several lab tests (cardiac ultrasound, chest X ray study, arterial blood gas analysis, etc.)

You can upload the photos here for a direct review and a second professional opinion.

Hope to have been helpful to you!

In case of any further questions, feel free to ask me again!

Kind regards,

Dr. Iliri

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Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again!

After reviewing your uploaded photos, I would explain that it seems to be a systemic reaction reaction. Though an allergic reaction may explain a part of the skin lesions, those purpura-like leg lesions may be due to several causes (systemic inflammation/infection, vasculitis, platelets disorder, etc.) should be sought as well.

Coming to this point, it is necessary to perform additional medical tests, like inflammatory markers (PCR, ESR), complete blood, complement titer, and several infections disease tests that should be guided by the patient recent medical history. A direct physical exam by an internist or infectious disease specialist could properly guide the differential diagnosis and treatment.

It is necessary to discuss with his attending physician on the above mentioned issues.

Regards,

Dr. Ilir Sharka
cardiologist

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Brief Answer:
I would explain:

Detailed Answer:
Hello again, dear Salhadin!

I was able to review your uploaded photos and information and would encourage you to discuss with his attending doctor on the above mentioned issues.

A systemic inflammation/infection should be first excluded behind the underlying allergic reaction. Not rarely similar skin disorders are an expression of an infection or a systemic disorder.

In addition, body temperature and other potential complaints should be monitored as well.

Let me know in case of any further questions.

Regards,
Dr. Iliri

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