Journal article
Bullous Henoch-Schonlein purpura. Case report
Revista Chilena de pediatría, Vol.89(1), pp.103-106
02/01/2018
DOI: 10.4067/S0370-41062018000100103
PMID: 29664511
Abstract
Henoch-Schonlein purpura (HSP) or IgA Vasculitis is the most common childhood vasculitis. The classic tetrad of signs and symptoms include palpable purpura, arthralgia, abdominal pain and renal disease. The occurrence of hemorrhagic bullae in children with HSP is rarely encountered. Objective: To report an unusual cutaneous manifestation of HSP in children. Case report: A 14-year-old girl complained about a 2-week painful bullous rash in both lower extremities and multiple arthralgias. There was no history of abdominal pain or urinary symptoms. In both lower extremities, there were numerous palpable purpura and hemmorrhagic bullae. In light of clinical findings, laboratory tests and skin biopsy are requested. The histopathology described intraepidermal blisters, acanthosis, spongiosis and perivascular dermal infiltrate. Direct immunofluorescence (IFD) (+) for IgA. The diagnosis of bullous HSP was made and treatment with endovenous corticosteroids was initiated. Three days after overlapping to oral corticosteroids, new ecchymotic lesions appeared in both legs. Due to the persistence of cutaneous involvement and negative control tests, azathioprine was associated obtaining a good response. Conclusion: Although bullous lesions in HSP does not add morbidity, it is often an alarming phenomenon with multiple differential diagnoses. The anti-inflamatory effect of corticoids is likely to be beneficial in the treatment of patients with severe cutaneous involvement through inhibition of proinflammatory transcription factors and decreasing the production of the metalloproteinases.
Details
- Title: Subtitle
- Bullous Henoch-Schonlein purpura. Case report
- Creators
- Trinidad Hasbun - Dr Exequiel Gonzalez Cortes Hosp, Pediat Serv, Pediat Dermatol Dept, Santiago, ChileXimena Chaparro - Dr Exequiel Gonzalez Cortes Hosp, Pediat Serv, Pediat Dermatol Dept, Santiago, ChileViera Kaplan - University of ChileFelipe Cavagnaro - CAS UDD Sch Med, Clin Alemana Santiago, Pediat Dept, Santiago, ChileAlex Castro - CAS UDD Sch Med, Clin Alemana Santiago, Pathol Anat Serv, Santiago, Chile
- Resource Type
- Journal article
- Publication Details
- Revista Chilena de pediatría, Vol.89(1), pp.103-106
- DOI
- 10.4067/S0370-41062018000100103
- PMID
- 29664511
- NLM abbreviation
- Rev Chil Pediatr
- ISSN
- 0370-4106
- eISSN
- 0717-6228
- Publisher
- Soc Chilena Pediatria
- Number of pages
- 4
- Language
- English
- Date published
- 02/01/2018
- Academic Unit
- Dermatology
- Record Identifier
- 9984966746102771
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