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Characteristic appearance of the rash of Henoch-Schonlein purpura (HSP)

Henoch–Schonlein purpura
Henoch–Schonlein purpura (HSP or anaphylactoid purpura) is the commonest childhood vasculitis, with an incidence between 13.5 and 24 per 100000 children under 14 years old, falling with
increasing age. "Vasculitis is a general term that refers to the inflammation of arteries, or blood vessels".
It is a multisystem disorder affecting the skin, joints (in 60–84 %) particularly ankles and knees, gastrointestinal tract with pain and gastrointestinal bleeding, and kidneys. The aetiology is unclear although preceding infection, particularly upper respiratory tract infection; there is a seasonal variation in incidence supporting an infectious aetiology. No single organism has been found to be associated with HSP.




For most children, Henoch–Schonlein purpura HSP is diagnosed by the appearance of the rash......purple, bruised rash on legs, buttocks or elsewhere. This is caused by red blood cells that leak out of the damaged blood vessels.
 The palpable purpuric rash of Henoch–Schonlein purpura in the classic distribution around the lateral malleoli,the ventral aspects of the feet,the buttocks and the extensor aspects of the legs.The rash may start with urticaria.
Joints: painful, brief swelling. The joints most frequently affected with pain and swelling are the ankles and the knees. Usually this only lasts from 1-3 days in the individual joints. Sometimes whole limbs will swell. The inflammation does not cause crippling arthritis.

Intestines: mostly abdominal pain, but can also include loss of appetite, diarrhea, vomiting and occasional blood in stools. Rarely, patients develop an abnormal bowel folding called intussusception.

Kidney: a significant number develop nephritis with an estimated 1 per cent developing endstage renal failure. 5 to 15 % of children requiring dialysis have Henoch–Schonlein purpura.