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Correspondence to Dr Kundan Mishra, [email protected]
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A previously healthy, 38-year-old man presented with non-pruritic rash over his legs and trunk noticed 2 hours back. Examination revealed non-palpable purpura over the limbs and trunk. There was multiple ‘wet purpura’ over the buccal mucosa, palate and tongue (figure 1A). He had mild pallor and direct ophthalmoscopy showed bilateral fundal haemorrhage with sparing of macula. There was no organomegaly or palpable lymphadenopathy. His investigation showed haemoglobin 125 g/L, white blood cell 8.7×109/L, platelet 7×109/L and normal peripheral smear. He was treated with intravenous methylprednisolone (1 g once a day x3 days) and received one single...