Swiss medical weekly
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Swiss medical weekly · Aug 1992
Case Reports[Schoenlein-Henoch syndrome in adults and skin infection].
Schoenlein-Henoch purpura is a rare disease in adults clinically characterized by palpable purpura, mainly on the legs, with varying degrees of gastrointestinal, articular and renal involvement. This syndrome is also characterized by IgA-vasculitis and its pathogenesis is still unclear, although it appears frequently after a viral or bacterial infection especially in the ORL sphere. We report here the cases of three adult patients who developed Schoenlein-Henoch purpura shortly after a bacterial infection of the skin, notably by Staphylococcus aureus.
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Non-thrombocytopenic palpable purpura is a characteristic lesion of cutaneous leukocytoclastic vasculitis. In association with manifestations in the gastrointestinal tract, kidney and/or joints, it forms the clinical entity of Henoch-Schönlein purpura. Among 27,510 inpatients in the years 1974 to 1989 from the CHDM Berne/St. ⋯ In contrast, among 8 additional cases from the same cohort, in which Henoch-Schönlein syndrome was diagnosed on admission to hospital, a drug etiology was suspected only in one patient. In these patients an involvement in addition to that of the skin of at least two other organ systems was documented. In our experience, a drug etiology should be considered in every case of leukocytoclastic vasculitis, but will mainly be validated in cases in which the lesions are limited to the skin.
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Several pathophysiologic mechanisms are known which induce neuropathic pain in presence of peripheral nerve damage. They help to explain the clinical features of neuropathic pain syndromes and why causal and symptomatic treatments can be effective. However, careful analysis of every pain syndrome is necessary in order to select the type of pain management required.