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TL;DR
This is a case report of a 7-year-old girl who presented with a painful retiform purpura rash, which was later found to be associated with newly diagnosed ulcerative colitis and autoimmune hepatitis.
JPGN reports · 5 authors, 3 centres
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This is a case report of a 7-year-old girl who presented with a painful retiform purpura rash, which was later found to be associated with newly diagnosed ulcerative colitis and autoimmune hepatitis.
A 7-year-old girl with sickle cell trait presented with a painful retiform purpura rash on her right leg. Initial workup, including skin biopsies, showed nonspecific dermatitis without vasculitis or thrombosis. Over several weeks, the rash progressed, and she developed colitic symptoms, elevated fecal calprotectin, and a positive antinuclear antibody. Endoscopy and colonoscopy confirmed ulcerative colitis, and a liver biopsy revealed autoimmune hepatitis. Systemic steroid treatment improved her pain and liver enzymes, but the rash continued to evolve over three months, developing a necrotic eschar and ulceration that slowly healed with supportive care. The case highlights retiform purpura as a cutaneous manifestation of underlying inflammatory bowel disease, possibly linked to the interplay between coagulation and inflammation.