Department of Pediatrics, Duke University Hospital, 2301 Erwin Rd, Durham, NC, 27705, USA.
Pediatr Rheumatol Online J. 2020 May 24;18(1):40. doi: 10.1186/s12969-020-00436-7.
Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. It has a characteristic rash described as palpable purpura that most frequently affects the distal lower extremities and buttocks. HSP rarely presents with bullous rash nor pulmonary nodules.
We present a novel case of a 12-years-old female with recurrent pediatric HSP with a combination of the rare manifestations of bullous rash and pulmonary nodules. She initially presented with the bullous rash, chest pain, cough, and abdominal pain. Patient was successfully treated with intravenous pulse corticosteroids followed by a high dose oral corticosteroid taper, with resolution of the bullous rash and pulmonary nodules.
The rare manifestations of scarring bullous rash and pulmonary nodules can be presenting features of pediatric HSP, the combination of which has not been previously reported. The treatment of intravenous corticosteroid resolved patient's abdominal symptoms, rash and pulmonary nodules.
过敏性紫癜（HSP）是儿童最常见的血管炎。它具有特征性皮疹，表现为可触及的紫癜，最常影响下肢远端和臀部。HSP 很少出现大疱性皮疹或肺结节。
我们报告了一例 12 岁女性的新病例，她患有复发性儿科 HSP，伴有罕见的大疱性皮疹和肺结节表现。她最初表现为大疱性皮疹、胸痛、咳嗽和腹痛。患者经静脉注射脉冲皮质类固醇治疗后，随后口服大剂量皮质类固醇逐渐减量，大疱性皮疹和肺结节消退。
瘢痕性大疱性皮疹和肺结节的罕见表现可作为儿科 HSP 的首发表现，两者的联合表现尚未见报道。静脉内皮质类固醇的治疗缓解了患者的腹部症状、皮疹和肺结节。
