An Unusual Association of Pyoderma Gangrenosum with Henoch-Schonlein Purpura in a Child

Abstract

Henoch-Schonlein purpura (HSP) is a systemic vasculitis affecting small vessels. Pyoderma gangrenosum (PG) is an uncommon, non-infectious, neutrophilic dermatosis. A sixteen-year-old boy was admitted to our clinic with arthralgia, palpable purpuric rush and a wound on the left lower extremity. Dermatological examination revealed an ulcer 3x3 cm in diameter covered with necrotic material and surrounded by a bluish ring. The lesion was found to be clinically compatible with pyoderma gangrenosum. Histological examination of the biopsy material taken from the purpuric rush was compatible with leukocytoclastic vasculitis. Direct immunofluorescence showed IgA class antibody and C3 deposition within the dermal capillaries. These findings were suggestive of HSP. We report a case of HSP with PG like ulcer. To the best of our knowledge, only one adult case of HSP with PG has been reported so far.