[Palpable purpura]

Abstract

Non-thrombocytopenic palpable purpura is a characteristic lesion of cutaneous leukocytoclastic vasculitis. In association with manifestations in the gastrointestinal tract, kidney and/or joints, it forms the clinical entity of Henoch-Schönlein purpura. Among 27,510 inpatients in the years 1974 to 1989 from the CHDM Berne/St. Gallen, 2 developed one, and a further patient as many as 4 episodes of leukocytoclastic vasculitis limited to the skin, which were probably related to drugs (most often compounds containing a sulfonamide, related structures or a penicillin). In contrast, among 8 additional cases from the same cohort, in which Henoch-Schönlein syndrome was diagnosed on admission to hospital, a drug etiology was suspected only in one patient. In these patients an involvement in addition to that of the skin of at least two other organ systems was documented. In our experience, a drug etiology should be considered in every case of leukocytoclastic vasculitis, but will mainly be validated in cases in which the lesions are limited to the skin.