Post-vomiting Purpura in children rare phenomenon but do occur

Eight-year-old male child who presented with red facial rash after a single episode of forceful vomiting following paracetamol syrup ingestion for headache.The patient denied experiencing pruritus or pain of the lesions.There is no preceding history of fever or upper respiratory tract infection.There are no similar lesions elsewhere in the body.The examination was unremarkable except for multiple non palpable purpura and few petechial rash (Figure 1).He had similar history of facial rash after cough.The father had similar episode in the past.The child had been seen by the pediatrician on the same day for common cold.Complete blood count done and showed hemoglobin of 126 g/L, platelets of 312 x 10 9 /L and white blood count of 5.87 x 10 9 /L.