The Evaluation and Management of Adult-Onset Henoch-Schonlein Purpura

Henoch-Schonlein Pupura (HSP) is a small vessel vasculitis resulting from immunoglobulin A (IgA)-mediated inflammation and characterized by leukocytoclastic angiitis and predominant cutaneous involvement. It is more common in children and characterized by a more benign, shorter and self-limiting course, in contrast to adults where it is relatively rarer but associated with a higher frequency of renal involvement and morbidity. This review discusses the contrasting epidemiological and clinical features between adult and childhood onset HSP, pathogenesis, uncommon clinical manifestations and the evidence for the use of corticosteroids and other immunosuppressive therapies and their influence on longterm outcomes.