Published on 02/04/2015 by admin
Filed under Internal Medicine
Last modified 02/04/2015
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154 Henoch–Schönlein purpura
Look at this patient’s legs.
• Ask the patient about the following:
• Purpuric rash over the legs (Fig. 154.1) and buttocks.
Fig. 154.1 Henoch–Schönlein purpura: palpable purpuric lesions.
Remember: Palpable purpura implies an inflammatory process, most classically cutaneous small cell vasculitis.
Proceed as follows:
• Tell the examiner that you would like to examine the rest of the body—including arms, body, scalp and behind the ears—for distribution of rash.
• Examine the mouth to confirm or rule out involvement of mucous membranes.
• Tell the examiner that you would like to examine the urine for haematuria.
This patient has purpuric rash over the legs and buttocks with renal involvement (lesions) caused by Henoch-Schönlein purpura (aetiology). I would like to know his 24-h urine output and levels of urea and electrolytes to determine renal function (functional status).
250 Cases in Clinical Medicine
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