Blistering eruptions in childhood Henoch-Schönlein syndrome: systematic review of the literature.
The occurrence of blistering eruptions in childhood Henoch-Schönlein syndrome has been so far addressed exclusively in individual case reports. To describe epidemiology, clinical presentation, and therapeutic options in Henoch-Schönlein patients ≤18 years of age with blistering eruptions, we completed a systematic literature search. For the final analysis, we retained 39 reports. Ten children with blisters were found in 7 (1.5%) case series containing a total of 666 unselected pediatric Henoch-Schönlein cases. We also found 41 individually documented cases of Henoch-Schönlein syndrome with blistering eruptions. Blistering eruptions and purpura were distributed very similarly, blisters developed concomitantly with palpable purpura or with a latency of ≤14 days, and 80% of the cases remitted within 4 weeks with a similar course in children managed expectantly and in those managed with steroids.


CONCLUSIONS
Blistering eruptions are rare in Henoch-Schönlein syndrome. They can be a source of diagnostic dilemma but do not have any prognostic value since they almost always spontaneously subside within 4 weeks. What is known: • Textbooks and reviews marginally refer to the occurrence of blistering eruptions in children with Henoch-Schönlein syndrome. What is new • Blistering eruptions occur in <2% of cases. • Blisters and purpura are distributed similarly, blisters develop concomitantly with purpura or with a latency of ≤14 days. • Almost all cases remit within 4 weeks with a similar course in children managed expectantly and in those managed with systemic steroids.
Pediatric Department of Southern Switzerland, 6500, Bellinzona, Switzerland.
Vera
V
Ramelli
University Children's Hospital Bern and University of Bern, Bern, Switzerland.|Pediatric Pharmacology and Pharmacogenetics, Hôpital Robert Debré, Paris, France.
Sebastiano A G
SA
Lava
Pediatric Department of Southern Switzerland, 6500, Bellinzona, Switzerland.|University Children's Hospital Bern and University of Bern, Bern, Switzerland.
Giacomo D
GD
Simonetti
Pediatric Department of Southern Switzerland, 6500, Bellinzona, Switzerland. mario.bianchetti@usi.ch.|Università della Svizzera Italiana, Lugano, Switzerland. mario.bianchetti@usi.ch.
Mario G
MG
Bianchetti
Pediatric Department of Southern Switzerland, 6500, Bellinzona, Switzerland.
Gian Paolo
GP
Ramelli
Pediatric unit, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Gregorio P
GP
Milani
D001768:Blister / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000188:drug therapy; D008297:Male; D017445:Skin Diseases, Vascular / Q000175:diagnosis / Q000188:drug therapy; D013256:Steroids / Q000627:therapeutic use
D013256:Steroids
Blister; Colchicine; Glucocorticoids; Purpura; Schönlein-Henoch; Vasculitis