How is rash characterized in Henoch-Schönlein purpura (IgA vasculitis)?

Updated: Jan 08, 2021
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Answer

The hallmark of the disease is the characteristic rash (see the image below), which appears in nearly all patients (though in as many as 50% of children, it may not be the presenting feature). The rash typically appears in crops, with new crops appearing in waves. Eruptions usually last an average of 3 weeks.

Characteristic rash of IgA vasculitis (Henoch-Schönlein purpura).

Characteristic rash of IgA vasculitis (Henoch-Schö Characteristic rash of IgA vasculitis (Henoch-Schönlein purpura).

Lesions tend to occur on the buttocks and upper thighs in younger children and on the feet, ankles, and lower legs in older children and adults. The primary differences between children and adults appear to be the chronicity and severity of the eruption in the latter population; bullae and ulcers are more common in adults, and cutaneous exacerbations may be seen for 6 months or longer. [69] Chan et al noted a case of IgAV presenting as painful bullae on both legs. [70]


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