Cutaneous manifestations of Henoch-Schönlein purpura in young children

We evaluated the anatomic distribution and pattern of skin involvement in 155 pediatric patients with Henoch-Schönlein purpura treated in our center over the last 20 years. Of these, 120 (77.4%) presented with cutaneous signs; only 10% of them had no leg involvement. Seven patients (4.5%) had edema of the hands, feet, or face. The mean age of this subgroup was 9.2+/-2.2 months, compared to 6.8+/-2.3 years for the entire group (p < 0.05). Skin biopsies were performed in 18 of these patients, including the 7 with edema, to confirm the clinical diagnosis. All biopsy specimens showed leukocytoclastic vasculitis, with IgA deposits in two and C3 deposits in one. It is important that clinicians keep in mind that an atypical presentation of Henoch-Schönlein purpura is not unusual.