A 14-year-old boy with recent antibiotic treatment for tonsillitis, presented to the emergency department with 1-week history of worsening rash and haemorrhagic bullae involving the bilateral legs, trunk and hands (figures 1 and 2). Laboratory results were significant for proteinuria (2+protein) and haematuria (1+, 5–10 red blood cells/high power field); 24 hours urinary protein and renal function were within normal limits. The patient had an inconclusive skin biopsy.
What is the most probable diagnosis?
Bullous Ig A vasculitis
Eosinophilic granulomatosis with polyangiitis
What is the best test which will establish the diagnosis in this patient?
What is first line of treatment in this patient?
Immunosuppressants such as azothioprine
What other systems can this condition affect besides the skin?
A, B and D
Questions Answers can be found on page 02.
- general paediatrics
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Contributors Both SY and MEB have contributed to this article.
Funding All funding for this study was provided by Section of Pediatric Emergency Medicine, Baylor College of Medicine and the Texas Children's Hospital.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.