REPORT OF A CASE
A 7-year-old girl was brought to the emergency room for examination of a bullous eruption on her legs for 7 days. She experienced intermittent migratory arthralgias and refused to bear weight on her left foot for the preceding 2 days. She had been well, except for an upper respiratory infection 1 month earlier. There was no history of fever, hematuria, abdominal pain, vomiting, or diarrhea. She was taking no medications.Physical examination revealed a healthy-appearing child with tender swelling of her left ankle. Cutaneous examination showed multiple purpuric plaques with polycyclic margins covering the shins (Figs 1 and 2). Several lesions had a central hemorrhagic bulla, while others showed rosettes of vesicles and bullae on a purpuric base. Purpuric papules were scattered on her buttocks and the extensor surfaces of her upper arms. The oral mucosa, palms, and soles were without lesions.Results from laboratory studies