Henoch- Schonlein purpura (lgA vasculitis) is the most common vasculitis in the pediatric population. It usually affects the skin, synovia, gastrointestinal tract, and kidneys. It usually presents as a palpable purpura. The occurrence of hemorrhagic bullae in children with HSP is an uncommon presentation. We present a case of an otherwise healthy 9-year-old male with a three-day history of erythematous maculopapular lesions over the lower extremItIes which progressed to violaceous plaques with central hemorrhagic bullae affecting the bilateral lower extremities, buttocks and arms. Odynophagia and intermittent abdominal pain were present. Histopathology revealed small vessel leukocytoclastic vasculitis and direct immunofluorescence (DIF) showed granular deposition of lgA and fibrinogen along the walls of the papillary dermal blood vessels. The patient was successfully treated with prednisone at 1 mg/kg/day and showed resolution of lesions within 1 week of treatment with no recurrence at 1 month follow-up. We stress the importance of having a high index of suspicion in these atypical presentations in order to prevent delay in diagnosis and achieve maximal treatment gains.

Introduction: Psoriasis is a chronic autoimmune disease that affects the skin, nails, and musculoskeletal system. Musculoskel- etal involvement, called psoriatic arthritis occurs in 10-25% of patients with psoriasis and can lead to disability if left untreated. Early detection and intervention of psoriatic arthritis has been shown to decrease morbidity. The Psoriasis Epidemiology Screening Tool (PEST) may detect the presence of psoriatic arthritis and has been validated in differ- ent countries. Currently, there is no Filipino version. Objectives: To translate, adapt, and validate PEST in Filipino language. Methods: In the first part of the study, PEST was translated and culturally adapted into Filipino. It was pretested in 30 participants. Three experts then assessed its content and face validity. After the content and face validity were met, 115 participants an- swered the Filipino version of the PEST questionnaire. Results: The Filipino version of the PEST questionnaire was comprehensible, clear and appropriate. All questions were relevant. Some words were edited per expert recommendation. One hundred fifteen adult patients were asked to answer the question- naire. It showed good reliability at 94%. Conclusion The Filipino Version of the PEST was found to be reliable and valid. Larger samples to determine the tool’s applica- bility is recommended.
Psoriasis