Haemorrhagic Bullous Lesion in Henoch-Schonlein Purpura
ABSTRACT: Henoch-Schonlein
purpura (HSP) is a vasculitis of the small vessels and the most common type of
vasculitis in children. Vesicles and haemorrhagic bullae were thought to be
rare in HSP and maybe difficult to diagnose. Purpose: To describe the rare case
of haemorrhagic bullous lesion in HSP. Case: A 15-year-old Javanese girl was
admitted to Dr. Soetomo General Hospital Surabaya with one week history of
multiple haemorrhagic blisters on her extremities, accompanied with joint pain,
abdominal pain, and severe nausea. Firstly, it’s only a few redness patches
then become numerous and changed to haemorrhagic blisters. A dermatological
examination shown multiple bullae and vesicles on multiple palpable
erythematous purpura. There were hypokalemia on laboratory examination and
histopathological examination concluded a leukocytoclastic vasculitis.
Discussion: Fluid balance, oral corticosteroid, oral antihistamine, antiemetic
injection,and potassium correction were administered to the patient.
Dexamethasone was discontinued because there was a presence of melena.
Symptomatic treatment was given and significantly improvement was achieved in
one month after treatment. Conclusion: Henoch-Schonlein purpura is diagnosed
based on history, physical, clinical, and histopathological examination. Vesicles
and haemorrhagic bullae are rare in HSP, and it does not seem to have any
prognosis value in the outcome of HSP.
Key words: Henoch-Schonlein
purpura, haemorrhagic bullous lesion, small vessel vasculitis
Penulis: Renata Prameswari,
Diah Mira Indramaya, Sawitri
Kode Jurnal: jpkedokterandd160604