In Henoch-Schonlein Purpura, which combination of symptoms is most characteristic?

• A. Palpable purpura on legs with abdominal pain and joint pain
• B. Malar rash with joint pain
• C. Oral ulcers with fever
• D. Hemoptysis with chest pain

Answer: (A)

Recognize the classic triad of Henoch-Schönlein purpura: palpable purpura on the legs, abdominal pain, and joint (arthralgia/arthritis) involvement. This IgA-mediated small-vessel vasculitis typically affects children and presents with a non-blanching, raised purpuric rash on the lower extremities, often accompanied by abdominal cramping or pain and swelling of large joints like knees and ankles. The combination of skin involvement with GI and joint symptoms is what makes this presentation distinctive.

Other patterns, such as a malar rash with joint pain, point more toward systemic lupus erythematosus; oral ulcers with fever can be seen in several conditions including lupus or other mucocutaneous diseases; and hemoptysis with chest pain suggests pulmonary involvement from another type of vasculitis or pulmonary disease, not the classic HSP picture.