Henoch-Schonlein Purpura

(Anaphylactoid Purpura; HSP; Vascular Purpura)

Pronounced: Hen-awk-shern-line purr-purr-ah


Henoch-Schonlein purpura (HSP) is inflammation of the blood vessels in the skin and other organs. It results in a specific rash when the skin is involved. The rash looks like bruising or small dots, referred to as purpura.


HSP is caused by an abnormal reaction of the immune system. It attacks healthy blood vessels. It is not clear why this happens.

The change in the immune system may be triggered by:

  • Bacterial or viral infections—some can be related to an insect bite
  • Certain medicines
  • Recent exposure to certain vaccines

Risk Factors

HSP is most common in children aged 2 to 11 years old, but it can happen at any age. Your chances are higher if you had:

  • An upper respiratory infection such as a cold
  • Exposure to vaccines, chemicals, cold weather, or insect bites


Symptoms may last for 4 to 6 weeks and may include:

  • Skin rash:
    • Reddish-purple spots that can be felt and are not itchy
    • Often appears on the buttocks or legs, may appear on the elbows
    • Red spots of various sizes
    • Bruising, usually below the waist
  • Pain in the joints—usually the knees and ankles
  • Belly pain
  • Blood in the urine
  • Swelling of the ankles
  • Swelling of the scrotum in males
  • Fever
  • Blood in the stool
  • Vomiting


The doctor will ask about your symptoms and health history. You may have:

  • A physical exam
  • Blood tests
  • Urine tests
  • Stool sample
  • Skin biopsy from an area of the rash

Skin Biopsy

Skin proceedure
Copyright © Nucleus Medical Media, Inc.


HSP usually gets better on its own. Your doctor may give you medicines if you are having problems. Medicines are used to:

  • Ease joint swelling and pain
  • Treat bacterial infections
  • Change how the immune system works


There is no way to prevent HSP since the cause is unknown.


American Autoimmune Related Diseases Association
Family Doctor—American Academy of Family Physicians


Caring for Kids—Canadian Paediatric Society
College of Family Physicians of Canada


Dillon MJ. Henoch-Schonlein purpura (treatment and outcome). Cleve Clin J Med. 2002;69(Suppl 2):SII121-SII123.
Henoch-Schonlein purpura. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated January 29, 2018. Accessed July 10, 2018.
Henoch-Schonlein purpura. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/henoch-schonlein-purpura. Updated July 24, 2017. Accessed July 10, 2018.
Henoch-Schonlein purpura. GARD—Genetic and Rare Diseases Information Center website. Available at: https://rarediseases.info.nih.gov/diseases/8204/henochschonlein-purpura. Updated April 14, 2013. Accessed July 10, 2018.
Reamy BV, Williams PM, Lindsay TJ. Henoch-Schonlein purpura. Am Fam Physician. 2009;80(7):697-704.
Saulsbury FT. Epidemiology of Henoch-Schonlein purpura. Cleve Clin J Med. 2002;69(Suppl 2):SII87-SII89.
Last reviewed May 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 7/10/2018

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