Background: Henoch-Schönlein purpura (HSP) is a small vessel IgA-predominant vasculitis.
Objective: To describe adult patients with HSP and determine if the distribution of skin lesions (ie, purpura above the waist or purpura below the waist only), is a predictor of significant renal involvement at the time of the skin biopsy and the months following.
Methods: A retrospective study on renal function from 72 adult patients with skin-biopsy proven HSP. Longitudinal renal data were analyzed after HSP diagnosis by using baseline renal function for comparison.
Results: Statistical analysis adjusted for sex, age, and baseline creatinine revealed a trend between HSP lesions only on the upper and lower extremities and long-term renal involvement (4.767, P = .067). Moreover, in another analysis adjusted for age and baseline creatinine, lesions located only on the upper and lower extremities significantly increased the odds of having long-term significant renal involvement (6.55, P = .049) in men.
Limitations: This retrospective study used patient information that was subject to selection bias.
Conclusion: In patients with HSP, skin lesion distribution on the extremities might be predictive of significant long-term renal involvement and might be critical for risk stratification and development of personalized diagnostics and therapeutics.
Keywords: HSP; Henoch-Schönlein purpura; direct immunofluorescence; hematuria; kidney; lesion distribution; lesion location; proteinuria; renal involvement; systemic involvement.
Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.