Recurrent Henoch-Schönlein Purpura with bullous rash and pulmonary nodules

Abstract

Background: Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. It has a characteristic rash described as palpable purpura that most frequently affects the distal lower extremities and buttocks. HSP rarely presents with bullous rash nor pulmonary nodules. Case presentation: We present a novel case of a 12-years-old female with recurrent pediatric HSP with a combination of the rare manifestations of bullous rash and pulmonary nodules. She initially presented with the bullous rash, chest pain, cough, and abdominal pain. Patient was successfully treated with intravenous pulse corticosteroids followed by a high dose oral corticosteroid taper, with resolution of the bullous rash and pulmonary nodules. Conclusion: The rare manifestations of scarring bullous rash and pulmonary nodules can be presenting features of pediatric HSP, the combination of which has not been previously reported. The treatment of intravenous corticosteroid resolved patient's abdominal symptoms, rash and pulmonary nodules.

Clinical spectrum and outcome of immunoglobulin A vasculitis in children: A 10‐year clinical study

“…In a recent review, only 23 paediatric cases were reported in the literature and almost all had renal involvement 40 . The disease is potentially fatal and a standard therapy is lacking 40,41 . A combination of steroids and immunosuppressants (cyclophosphamide or azathioprine) has been used in previous reports 40,42 .…”

“…40 The disease is potentially fatal and a standard therapy is lacking. 40,41 A combination of steroids and immunosuppressants (cyclophosphamide or azathioprine) has been used in previous reports. 40,42 In our experience, our patient had a resolution of proteinuria after 6 weeks of initiating cyclosporin therapy, without any late sequelae.…”