A Pulsating Leg

This brief case report highlights a rare manifestation of Quincke’s sign in a 21-month-old boy who presented with a pulsating rash on his left lower leg, accompanied by fever. Physical examination showed a blanching and flushing erythematous plaque that pulsed synchronously with his heartbeat, resembling capillary pulsations commonly seen in the fingernail beds in cases of aortic insufficiency. However, in this instance, the localized phenomenon occurred at the site of a suspected insect bite. The authors propose that vasodilation and edema compromised arteriolar pressure during diastole, resulting in visible capillary pulsations. Treatment with oral dimethindene maleate led to rapid resolution of symptoms within hours, and complete recovery by day three.

This brief case report highlights a rare manifestation of Quincke’s sign in a 21-month-old boy who presented with a pulsating rash on his left lower leg, accompanied by fever. Physical examination showed a blanching and flushing erythematous plaque that pulsed synchronously with his heartbeat, resembling capillary pulsations commonly seen in the fingernail beds in cases of aortic insufficiency. However, in this instance, the localized phenomenon occurred at the site of a suspected insect bite. The authors propose that vasodilation and edema compromised arteriolar pressure during diastole, resulting in visible capillary pulsations. Treatment with oral dimethindene maleate led to rapid resolution of symptoms within hours, and complete recovery by day three.