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Forum Name: Pediatric Topics

Question: HSP or not?


 rosemom - Wed Aug 03, 2005 3:20 pm

My 17-yr-old son has been diagnosed with HSP. When he was 9, he had an upper respiratory infection, stomach ache, and then broke out in a flat, red, circular rash with purple in the middle. The rash was warm to the touch, and only on his joints: his ankles, knees, elbows, and fingers. Since, then, he has continued to have outbreaks 2-3 times a year for the last 8 years, which I understand to be very unusual for HSP. In addition, his rash is never on his buttocks and is never raised, which is supposed to be typical for HSP. Recently, the rash also broke out on his palms, he is getting more frequent headaches, and he reports that his stomach often hurts (particularly after eating). Is this really HSP? What steps should we take to determine what is actually happening?

As an aside that may or may not help, his identical twin brother was diagnosed with lymphomatoid papulosa at nine as well, about six months before he had the first outbreak of HSP.

Thank you very much for your time.
 Dr. Heba Ismail - Mon Aug 08, 2005 9:43 am

Hello,
I agree this is not a very typical picture for HSP to present with, but it can occur.
Regretfully, there are no specific lab studies which are conclusive, but a biopsy from the skin lesions may be very helpful in doubtful cases.
Also, if it does turn out to be HSP, you must watch out for your child's kidneys, as recurrent cases are usually associated with a higher incidence of kideny affection.

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