Bullous lesions in Henoch Schönlein Purpura as indication to start systemic prednisone.
Henoch Schönlein Purpura (HSP) is usually mild and self-limiting, but it may be accompanied by severe complications such as bullous lesions. We describe the use of systemic prednisone in two patients with bullous lesions in HSP. The first patient presented with progressive bullous lesions distributed on the limbs that evolved into painful ulcers and necrosis. These were further complicated by a secondary skin infection. He then received 1 mg/kg/day prednisone after 9 days. Patient 2, a 10-year-old boy, presented with HSP and bullous lesions and received intravenous prednisone 1 mg/kg/day within 48 h after appearance of the bullous lesions. He recovered rapidly without any complications.


CONCLUSIONS
To reduce the severity of HSP related bullous lesions and their sequelae, we would propose starting prednisone (1 mg/kg/day) as soon as the bullae appear. In addition to prednisone, analgesics and specialist skin care for bullae should be started.
Den Boer
S L
SL
Department of Pediatrics, St Antonius Hospital, Nieuwegein, The NetherlandsDepartment of Pediatric Dermatology/Allergology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatric Rheumatology and Immunology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatrics, Meander Medical Centre Amersfoort, Amersfoort, The NetherlandsDepartment of Dermatology, Meander Medical Centre Amersfoort, Amersfoort, The Netherlands.
Pasmans
Sgma
S
Department of Pediatrics, St Antonius Hospital, Nieuwegein, The NetherlandsDepartment of Pediatric Dermatology/Allergology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatric Rheumatology and Immunology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatrics, Meander Medical Centre Amersfoort, Amersfoort, The NetherlandsDepartment of Dermatology, Meander Medical Centre Amersfoort, Amersfoort, The Netherlands.
Wulffraat
N M
NM
Department of Pediatrics, St Antonius Hospital, Nieuwegein, The NetherlandsDepartment of Pediatric Dermatology/Allergology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatric Rheumatology and Immunology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatrics, Meander Medical Centre Amersfoort, Amersfoort, The NetherlandsDepartment of Dermatology, Meander Medical Centre Amersfoort, Amersfoort, The Netherlands.
Ramakers-Van Woerden
N L
NL
Department of Pediatrics, St Antonius Hospital, Nieuwegein, The NetherlandsDepartment of Pediatric Dermatology/Allergology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatric Rheumatology and Immunology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatrics, Meander Medical Centre Amersfoort, Amersfoort, The NetherlandsDepartment of Dermatology, Meander Medical Centre Amersfoort, Amersfoort, The Netherlands.
Bousema
M T
MT
Department of Pediatrics, St Antonius Hospital, Nieuwegein, The NetherlandsDepartment of Pediatric Dermatology/Allergology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatric Rheumatology and Immunology, Wilhelmina's Children Hospital, University Medical Centre Utrecht, Utrecht, The NetherlandsDepartment of Pediatrics, Meander Medical Centre Amersfoort, Amersfoort, The NetherlandsDepartment of Dermatology, Meander Medical Centre Amersfoort, Amersfoort, The Netherlands.
D015746:Abdominal Pain / Q000209:etiology; D001768:Blister / Q000188:drug therapy* / Q000209:etiology; D002648:Child; D004334:Drug Administration Schedule; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011241:Prednisone / Q000008:administration & dosage*; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
D011241:Prednisone