title: [Hemorrhagic vesicle-bullous lesions in Henoch-Schönlein purpura and review of literature].
abstract: BACKGROUND
  The characteristic feature of Henoch-Schönlein purpura (HSP) is palpable purpura, however hemorrhagic vesicles and blisters have been rarely reported.
  
  
  METHODS
  From January 1983 to December 2007, 5079 patients were followed in our Pediatric Rheumatology Unit, 232 (4.6%) of them with the diagnosis of HSP. Three female patients (1.3%) presented hemorrhagic vesicles and bullous lesions associated with palpable purpura. In one case the lesions were severe and widespread, and in another they preceded the typical purpuric lesions. In both cases, skin biopsy disclosed leukocytoclastic vasculitis with IgA and C3 deposits. Two patients healed with residual lesions: ulcers in one case and skin hyperpigmentation in two of them.
  
  
  CONCLUSIONS
  Hemorrhagic vesicle-bullous lesions are rare in HSP. This manifestation may represent a more severe and prolonged disease course with scars or may precede typical skin lesions.
authors.affiliation: Programa de Ciências Médicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), SP, Brazil.
authors.forename: Carlos Rabelo
authors.initials: CR
authors.lastname: Júnior
authors.forename: Renata
authors.initials: R
authors.lastname: Yamaguti
authors.forename: Aline Miranda
authors.initials: AM
authors.lastname: Ribeiro
authors.forename: Bárbara Araújo
authors.initials: BA
authors.lastname: Melo
authors.forename: Lúcia Arruda
authors.initials: LA
authors.lastname: Campos
authors.forename: Clovis Almeida
authors.initials: CA
authors.lastname: Silva
mesh_terms: D001768:Blister / Q000209:etiology* / Q000473:pathology; D002648:Child; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000473:pathology; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*