PMC6349767_01
An acute papulovesicular rash of both legs (a) rapidly evolved into palpable purpura and hemorrhagic-bullous lesions of variable size ranging from 5 to 40 mm (b,c).
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F1
An otherwise healthy 5-year-old boy presented with an acute papulovesicular rash of both legs (Figure 1a) and intermittent abdominal pain. Nine days after the onset of disease the skin lesions at the arms, legs, feet and ankles rapidly evolved into palpable purpura and hemorrhagic-bullous lesions of variable size ranging from 5 to 40 mm (Figures 1b,c).
Skin biopsy of one lesion in H&E staining revealing signs of a small vessel leukocytoclastic vasculitis limited to the upper dermis.
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F2
A skin biopsy was performed and histological examination showed signs of a small vessel leukocytoclastic vasculitis limited to the upper dermis (Figure 2), and direct immunofluorescence analysis revealed IgA and C3 deposits in vessel walls, compatible with HSP.
Hemorrhagic bullae developed on both feet an lower legs (a-c). A deep necrosis resulting from a large blister at the dorsum of the right feet evolved (a,b) neccessitating autologous skin transplantation. Re-examination 11 months after disease onset showed complete clinical remission of disease with re-epithelialization of affected areas (d-f).
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F3
Although fading of inflammation paralleled healing of most erosions, a deep necrosis resulting from a large blister at the dorsum of the right foot persisted (Figures 3a-c) so that autologous skin transplantation was performed. Re-examination 11 months after disease onset showed complete clinical remission of disease with re-epithelialization but also scarring of some affected areas (Figures 3d-f).