Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pediatrics
Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Case report

Hemorrhagic bullous lesions in Henoch-Schönlein purpura: a case report and review of the literature

Authors: Hung-Wen Su, Chiu-Yu Chen, Yee-Hsuan Chiou

Published in: BMC Pediatrics | Issue 1/2018

Login to get access

Abstract

Background

Henoch-Schönlein purpura (HSP) is a common vasculitis in childhood characterized by purpura, arthritis, abdominal pain and renal involvement. However, bullous HSP is a rare cutaneous manifestation, and a few cases have been reported.

Case presentation

Herein, we report a 15-year-old male with bullous HSP who presented with severe abdominal pain and hemorrhagic bullous lesions over his lower extremities. He was treated with corticosteroid, after which the symptoms improved dramatically. No recurrence was noted after follow-up, though scarring was present. We also reviewed the literature related to bullous HSP and identified 39 cases, most of whom were treated with corticosteroids.

Conclusion

Clinicians should be aware of the atypical types of HSP, including bullous HSP. Most patients with bullous HSP have a good prognosis.
Literature
1.
Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: final classification criteria. Ann Rheum Dis. 2010;69(5):798–806.CrossRefPubMed
2.
Saulsbury FT. Henoch-Schonlein Purpura in children report of 100 patients and review of the literature. Medicine. 1999;78:395–409.CrossRefPubMed
3.
Trapani S, Micheli A, Grisolia F, Resti M, Chiappini E, Falcini F, et al. Henoch Schonlein Purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature. Semin Arthritis Rheum. 2005;35(3):143–53.CrossRefPubMed
4.
Abdel-Al YK, Hejazi Z, Majeed H. Henoch-Schönlein purpura in Arab children: analysis of 52 cases. Trop Geogr Med. 1990;42:52–7.PubMed
5.
Gardner-Medwin JMM, Dolezalova P, Cummins C, Southwood TR. Incidence of Henoch-Schonlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet. 2002;360:1197–202.CrossRefPubMed
6.
Vanesa CR, José LH, Francisco OS, Javier L, Natalia PF, Maria CGV, et al. Relapses in patients with Henoch–Schönlein purpura: analysis of 417 patients from a single center. Medicine. 2016;95(28):e e4217.CrossRef
7.
Cream JJ, Gumpel JM, Peachey RDG. Schönlein-Henoch purpura in the adult. A study of 77 adults with anaphylactoid or Schönlein-Henoch purpura. Q J Med. 1970;156:461–84.
8.
Tancrede-Bohin E, Ochonisky S, Vignon-Pennamen M-D, Flageul B, Morel P, Rybojad M. Schönlein-Henoch purpura in adult patients: predictive factors for IgA glomerulonephritis in a retrospective study of 57 cases. Arch Dermatol. 1997;133(4):438–42.CrossRefPubMed
9.
10.
Chen CB, Garlapati S, Lancaster JD, Zinn Z, Bacaj P, Patra KP. Bullous Henoch-Schönlein Purpura in Children. Cutis. 2015;96(4):248–52.PubMed
11.
Park SE, Lee JH. Haemorrhagic bullous lesions in a 3-year-old girl with Henoch-Schölein purpura. Acta Paediatr. 2011;100(7):e283–4.CrossRefPubMed
12.
AKC L, WLM R. Hemorrhagic bullous lesions in a child with Henoch-Schönlein Purpura. Pediatr Dermatol. 2006;23(2):139–41.CrossRef
13.
Kobayashi T, Sakuraoka K, Iwamoto M, Kurihara S. A case of anaphylactoid purpura with multiple blister formation: possible pathophysiological role of gelatinase (MMP-9). Dermatology. 1998;197(1):62–4.CrossRefPubMed
14.
Ronkainen J, Koskimies O, Ala-Houhala M, Antikainen M, Merenmies J, Rajantie J, et al. Early prednisone therapy in Henoch-Schonlein purpura: a randomized, double-blind, placebo-controlled trial. J Pediatr. 2006;149(2):241–7.CrossRefPubMed
15.
Weiss PF, Feinstein JA, Luan X, Burnham JM, Feudtner C. Effects of corticosteroid on Henoch-Schonlein purpura: a systematic review. Pediatrics. 2007;120(5):1079–87.CrossRefPubMedPubMedCentral
16.
Weiss PF, Klink AJ, Localio R, Hall M, Hexem K, Burnham JM, et al. Corticosteroids may improve clinical outcomes during hospitalization for Henoch-Schonlein purpura. Pediatrics. 2010;126(4):674–81.CrossRefPubMedPubMedCentral
17.
den Boer SL, Pasmans SG, Wulffraat NM, Ramakers-Van Woerden NL, Bousema MT. Bullous lesions in Henoch Schönlein Purpura as indication to start systemic prednisone. Acta Paediatr. 2010;99(5):781–3.CrossRefPubMed
18.
Park SJ, Kim JH, Ha TS, Shin JI. The role of corticosteroid in hemorrhagic bullous Henoch Schönlein purpura. Acta Paediatr. 2011;100(7):e2–3. author reply e-4CrossRef
19.
Trapani S, Mariotti P, Resti M, Nappini L, Martino M, Falcini F. Severe hemorrhagic bullous lesions in Henoch Schonlein purpura: three pediatric cases and review of the literature. Rheumatol Int. 2010;30(10):1355–9.CrossRefPubMed
20.
Mehra S, Suri D, Dogra S, Gupta A, Rawat A, Saikia B, et al. Hemorrhagic bullous lesions in a girl with Henoch Schönlein purpura. Indian J Pediatr. 2014;81(2):210–1.CrossRefPubMed
21.
22.
Chan KHN, Tang WYM, Lo KK. Bullous lesions in Henoch-Schönlein purpura. Pediatr Dermatol. 2007;24(3):325–6.CrossRefPubMed
23.
Maguiness S, Balma-Mena A, Pope E, Weinstein M. Bullous Henoch-Schonlein purpura in children: a report of 6 cases and review of the literature. Clin Pediatr. 2010;49(11):1033–7.CrossRef
24.
Garland JS, Chusid MJ. Henoch-Schöenlein purpura: association with unusual vesicular lesions. Wis Med J. 1985;84:21–3.PubMed
25.
Bari M, Cohen BA. Purpuric vesicular eruption in a 7-year-old girl. Arch Dermatol. 1990;126(11):1497–8.CrossRefPubMed
26.
Wananukul S, Pongprasit P, Korkij W. Henoch-Schonlein purpura presenting as hemorrhagic vesicles and bullae: case report and literature review. Pediatr Dermatol. 1995;12(4):314–7.CrossRefPubMed
27.
Saulsubury FT. Hemorrhagic bullous lesions in Henoch-Schönlein purpura. Pediatr Dermatol. 1998;15(5):357–9.CrossRef
28.
Liu PM, Bong CN, Chen HH, Huang YC, Huang CC, Yang KD, et al. Henoch-Schönlein purpura with hemorrhagic bullae in children: report of two cases. J Microbiol Immunol Infect. 2004;37:375–8.PubMed
29.
Ishii Y, Takizawa T, Arakawa H, Saga R, Mochizuki H, Tokuyama K, et al. Hemorrhagic bullous lesions in Henoch-Schönlein purpura. Pediatr Int. 2005;47:694–7.CrossRefPubMed
30.
Korver A, Moons P. Diagnostic image (329). A girl with haemorrhagic bullae. Ned Tijdschr Geneeskd. 2007;151:1403.PubMed
31.
Aydinoz S, Karademir F, Suleymanoglu S, Ozkaya H, Ersen A, Gocmen I. An unusual manifestation of Henoch-Schonlein purpura: haemorrhagic bullous lesions. N Z Med J. 2007;120:1267.
32.
Abdul-Ghaffar S, Chan SK, Burrows NP. Haemorrhagic bullae in a child with Henoch-Schönlein purpura. Br J Dermatol. 2007;156(6):1408.CrossRef
33.
Júnior CR, Yamaguti R, Ribeiro AM, Melo BA, Campos LA, Silva CA. Hemorrhagic vesicle-bullous lesions in Henoch-Schönlein purpura and review of literature. Acta Reumatol Port. 2008;33(4):452–6.PubMed
34.
Kausar S, Yalamanchili A. Management of haemorrhagic bullous lesions in Henoch-Schonlein purpura: is there any consensus? J Dermatolog Treat. 2009;20(2):88–90.CrossRefPubMed
35.
36.
37.
38.
Hooper JE, Lee C, Hindley D. Case report: bullous Henoch-Schönlein purpura. Arch Dis Child. 2016;101(2):124.CrossRefPubMed
Metadata
Title
Hemorrhagic bullous lesions in Henoch-Schönlein purpura: a case report and review of the literature
Authors
Hung-Wen Su
Chiu-Yu Chen
Yee-Hsuan Chiou
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-1117-8

Other articles of this Issue 1/2018

BMC Pediatrics 1/2018 Go to the issue

Research article

Residents’ breastfeeding knowledge, comfort, practices, and perceptions: results of the Breastfeeding Resident Education Study (BRESt)

Research article

Functional profiles of children with cerebral palsy in Jordan based on the association between gross motor function and manual ability

Research article

Measuring empathy in pediatrics: validation of the Visual CARE measure

Research article

Effects of combat training on visuomotor performance in children aged 9 to 12 years - an eye-tracking study

Case report

Rare presentation of an atrial myxoma in an adolescent patient: a case report and literature review

Research article

Efficacy of levetiracetam for neonatal seizures in preterm infants