Purpuric lip lesions in a young boy with IgA vasculitis

Excerpt

A previously healthy 6-year-old boy presented to the pediatrics department with skin rash, pain in the right ankle joint, and abdominal pain. Examination showed an afebrile child with diffuse palpable purpura over lower limbs (Fig. 1a), buttocks, trunk, upper limbs, palms, and soles with swelling and restricted movements of right ankle joint. Purpuric non-blanchable lesions were also noted over the lips (Fig. 1b). No pallor or lymphadenopathy was noted. Systemic and oral examination was unremarkable. Investigations showed normal hemoglobin (13.5 g/dL), platelet count (402 X 10⁹/L), urine examination and renal functions (Urea: 7.5 mg/dl, creatinine 0.43 mg/dl). Antinuclear antibody (ANA) by indirect immunofluorescence was negative. Skin biopsy was not performed. A diagnosis of IgA vasculitis was proffered. He received intravenous dexamethasone for painful abdomen followed by oral prednisolone for 7 days which was gradually tapered over 2 weeks. Purpuric lesions over lips resolved parallel with the generalized palpable purpura during follow-up visit after 2 weeks.

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