The enigma of adult onset Henoch Schoenlein purpura and leucocytoclastic Vasculits: a case report

Authors

  • Vasudha A. Belgaumkar Department of Skin and VD, B. J. Government Medical College, Pune, Maharashtra, India
  • Ravindranath B. Chavan Department of Skin and VD, B. J. Government Medical College, Pune, Maharashtra, India
  • Nitika S. Deshmukh Department of Skin and VD, B. J. Government Medical College, Pune, Maharashtra, India
  • Ranjitha K. Gowda Department of Skin and VD, B. J. Government Medical College, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20211718

Keywords:

Leukocytoclastic vasculitis, Henoch Schoenlein purpura, Hypersensitivity vasculitis

Abstract

Leukocytoclastic vasculitis (LCV), also known as hypersensitivity vasculitis is a small vessel inflammatory disease which mainly involves the postcapillary venules. It can be idiopathic or secondary to connective tissue diseases, infection, malignancy. A 39 year old male presented with a recurrent episode of multiple palpable purpurae over the legs, trunk, back and upper limbs with diffuse abdominal pain, bloody diarrhoea and arthralgia. Anti-nuclear antibodies (ANA) were positive, but ANA profile was equivocal. Histopathological examination confirmed leukocytoclastic vasculitis. A final diagnosis of Henoch Schoenlein purpura (HSP) was reached based on EULAR Criteria. He was treated with tapering doses of prednisolone, hydroxychloroquine and bed rest with limb elevation. All symptoms and lesions gradually resolved. Various sub-types of cutaneous small vessel vasculitis may mimic each other, warranting a meticulous evaluation. Adult onset HSP though rare must be considered in the differential diagnosis of LCV, which might be the presenting manifestation of an underlying connective tissue disease. Hence long-term follow-up with stringent clinical and laboratory monitoring is recommended.

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Published

2021-04-27

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Section

Case Reports