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October 1996, Vol 132, No. 10 >
Article | October 1996

Purpuric Eruption With Bloody Diarrhea in an Adult

CPT Peter C. Young, MCMAJ ; Stephen J. Krivda, MCLTC ; Paul M. Benson, MCCOL ; Purnima Sau, MC
[+] Author Affiliations

USA; USA; USA; USA; Walter Reed Army Medical Center, Washington, DC


Arch Dermatol. 1996;132(10):1244-1244. doi:10.1001/archderm.1996.03890340109020
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REPORT OF A CASE  An 18-year-old white man was admitted to the Internal Medicine Service with a 9-day history of abdominal cramps, nausea, vomiting, bloody diarrhea, and a pruritic, papular rash over his extremities. Seven days before admission, he was treated empirically with amoxicillin. The rash improved, but 2 days before admission, the patient experienced migratory arthralgias and myalgias and a nonpruritic, purpuric eruption on his extremities. The day before admission, his medication was switched from amoxicillin to erythromycin. A review of his systems revealed no recent upper respiratory tract infections or fevers.On admission, the patient had a low-grade fever (temperature, 41.1°C), a pulse rate of 93/min, and a blood pressure reading of 112/46 mm Hg. A stool sample was guaiac positive. Skin examination revealed palpable purpuric lesions on the lower part of both legs (Figure 1). There was also mild involvement of the forearms, but the palms and

REFERENCES

1 +
Gammon WR, Wheeler CE Jr.  Urticarial vasculitis . Arch Dermatol. 1979;;115: 76-80.
2 +
Green ST, Natarajan S.  The Koebner phenomenon in anaphylactoid purpura . Cutis. 1986;;38:56-57.
3 +
Hurwitz S.  Vasculitic syndromes . In: The Skin and Systemic Disease in Children . St Louis, Mo: Mosby—Year Book Inc; 1985;:35-64.
4 +
Hene RJ, Velthuis P, van de Wiel A, Klepper D, Dorhout Mees EJ, Kater L.  The relevance of IgA deposits in vessel walls of clinically normal skin . Arch Intern Med. 1986;;146:745-749.
5 +
Rosenblum ND, Winter HS.  Steroid effects in the course of abdominal pain in children with Henoch-Schönlein purpura . Pediatrics . 1987;;79:1018-1021.
6 +
Utani A, Ohta M, Shinya A, et al.  Successful treatment of adult Henoch-Schönlein purpura with factor XIII concentrate . J Am Acad Dermatol. 1991;; 24:438-442.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Gammon WR, Wheeler CE Jr.  Urticarial vasculitis . Arch Dermatol. 1979;;115: 76-80.
2 +
Green ST, Natarajan S.  The Koebner phenomenon in anaphylactoid purpura . Cutis. 1986;;38:56-57.
3 +
Hurwitz S.  Vasculitic syndromes . In: The Skin and Systemic Disease in Children . St Louis, Mo: Mosby—Year Book Inc; 1985;:35-64.
4 +
Hene RJ, Velthuis P, van de Wiel A, Klepper D, Dorhout Mees EJ, Kater L.  The relevance of IgA deposits in vessel walls of clinically normal skin . Arch Intern Med. 1986;;146:745-749.
5 +
Rosenblum ND, Winter HS.  Steroid effects in the course of abdominal pain in children with Henoch-Schönlein purpura . Pediatrics . 1987;;79:1018-1021.
6 +
Utani A, Ohta M, Shinya A, et al.  Successful treatment of adult Henoch-Schönlein purpura with factor XIII concentrate . J Am Acad Dermatol. 1991;; 24:438-442.

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