(BMJ)—A 5-yo boy presented to the ED w/ abdominal pain and a painful, red, swollen penis, w/o dysuria or hx of trauma. One week prior, he had had bronchitis, which was treated w/ albuterol. Exam: purpuric rash on penis; edema of R hand; petechial rash on legs. Labs: UA, CBC, coagulation panel, renal fxn tests all normal. What’s the dx?
Henoch-Schönlein purpura
Idiopathic thrombocytopenic purpura
Nonaccidental injury
Adverse drug reaction
Antiphospholipid antibody syndrome
You are correct. Henoch-Schönlein purpura is the most common immune-mediated systemic vasculitis in children. Penile manifestations are rare and include thrombosis, priapism, and cutaneous purpuric lesions. No correlation between genitourinary involvement and renal complications exists. This pt was treated w/ prednisone x6 days because of concurrent abdominal pain. Abdominal sx resolved in 1 day, and penile lesions resolved 1wk later. One-month f/u showed no hematuria or proteinuria and a normal BP.

Archives of Disease in Childhood 2020;105:311