Clinical Case Database / Category: Patient Management

An unusual rash in a young woman - differential diagnosis and management of a vasculitic rash with systemic features

Publication details

Clive Kelly, MBBS, MD, FRCP
Foundation Years Journal, volume 6, issue 2, p.29 (123Doc Education, London, February 2012)


We present the case of a young lady aged 28 who developed an extensive skin rash over her lower limbs following a viral infection. The features were those of a palpable purpura and were associated with abdominal pain, diarrhoea which became bloody, arthralgia and asymptomatic haematuria. She had a low grade fever and elevated acute inflammatory markers. A clinical diagnosis of Henoch-Schönlein purpura was made and prednisone commenced at the dose of 20mg daily. A rapid symptomatic improvement followed, with resolution of the abdominal pain and diarrhoea, followed by a more gradual reduction in the rash over several weeks.

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Clive Kelly, MBBS, MD, FRCP

Consultant Physician and Rheumatologist, Gateshead
Departments of Medicine and Rheumatology,
Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE9 6SX


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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