Abstract
A 73-year-old man visited our clinic because of various cutaneous complications on the extremities consistingof purpura, blisters, hemorrhagic bullae and thick crust, resulting in development of necrotic ulcers. Histopathologically, there were infiltration of leukocytes, nuclear dusts, and fibrinoid degeneration of blood vessels, which were findings that were compatible with those of leukocytoclastic vasculitis. Urinalysis revealed microscopic hematuria and proteinuria. Furthermore, endoscopic examination displayed a tubular adenocarcinoma in the sigmoid colon in addition to gastric ulcer. Based on these findings, we diagnosed this case as Henoch-Schonlein purpura, and prednisolone was orally administered, which was followed by a rapid improvement of skin lesions as well as gastric complications. Henoch-Schonlein purpura in the elderly may demonstrate unusual cutaneous complications, includingblisters, hemorrhagic bullae, and skin ulcers. Moreover, Henoch-Schönlein purpura in the elderly may be associated with solid-organ malignancies. It is therefore suggested that examination for internal malignancies should be considered in connection with the management of Henoch-Schönlein purpura, especially in elderly patients.
