Recurrent Henoch-Schönlein Purpura with bullous rash and pulmonary nodules

Pediatr Rheumatol Online J. 2020 May 24;18(1):40. doi: 10.1186/s12969-020-00436-7.

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.

Keywords: Bullous rash.; Henoch-Schönlein purpura; Pulmonary nodules..

Publication types

  • Case Reports

MeSH terms

  • Biopsy, Fine-Needle
  • Bronchoalveolar Lavage Fluid
  • Chest Pain / drug therapy
  • Chest Pain / physiopathology
  • Child
  • Complement C3
  • Cough
  • Female
  • Fluorescent Antibody Technique, Direct
  • Gabapentin / therapeutic use
  • Glucocorticoids / therapeutic use
  • Humans
  • IgA Vasculitis / diagnostic imaging
  • IgA Vasculitis / drug therapy
  • IgA Vasculitis / pathology
  • IgA Vasculitis / physiopathology*
  • Image-Guided Biopsy
  • Immunoglobulin A
  • Leg Dermatoses / drug therapy
  • Leg Dermatoses / pathology
  • Leg Dermatoses / physiopathology
  • Multiple Pulmonary Nodules / diagnostic imaging
  • Multiple Pulmonary Nodules / drug therapy
  • Multiple Pulmonary Nodules / physiopathology*
  • Neuralgia / drug therapy
  • Neuralgia / physiopathology
  • Recurrence
  • Skin Diseases, Vesiculobullous / drug therapy
  • Skin Diseases, Vesiculobullous / pathology
  • Skin Diseases, Vesiculobullous / physiopathology*
  • Tomography, X-Ray Computed

Substances

  • Complement C3
  • Glucocorticoids
  • Immunoglobulin A
  • Gabapentin