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A 29-year-old man presented with severe abdominal pain, skin lesions on the lower extremities, and arthralgia on the knee. Skin lesions demonstrated purpura on the lower extremities (Fig. 1). Endoscopic examination revealed petechiae in the stomach (Fig. 2) as previously reported.1 A skin biopsy taken from purpura showed leukocytoclastic vasculitis with perivascular dense neutrophilic infiltration, numerous nuclear dusts, and extravasated erythrocytes (Fig. 3). A biopsy from petechiae in the stomach demonstrated extravasation of erythrocytes with mononuclear cell infiltration in the stroma (Fig. 4).

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Figure 1. Purpura on the lower extremities

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Figure 2. Petechiae in the stomach (endoscopic examination)

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Figure 3. Histopatological findings from purpura in the skin showed leukocytoclastic vasculitis with perivascular dense neutrophil infiltration, numerous nuclear dusts and extravasated erythrocytes (H&E ×100)

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Figure 4. Histopathological findings from petechiae in the stomach demonstrated extravasation of erythrocytes with mononuclear cell infiltration in the stroma (H&E ×100)

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Henoch–Schönlein purpura is immune-complex systemic vasculitis of the small vessels of the skin, gastrointestinal tract, kidney, and joints.2 The patient was treated with oral prednisolone (20 mg/day), carbazochrome sodium sulfonate (90 mg/day), tranexamic acid (750 mg/day), and ascorbic acid (600 mg/day) on bed rest. Afterwards, abdominal pain, skin lesions, and arthralgia subsided promptly.

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