Henoch-Schonlein purpura (HSP) is a disease that manifests symptoms of purple spots on the skin, joint pain, gastrointestinal symptoms, and glomerulone-phritis. HSP is a type of hypersensitivity vasculitis and inflammatory response within the blood vessel. It is caused by an abnormal response of the immune system. The exact cause for this disorder is unknown. The syndrome is usually seen in children, but people of any age maybe affected. It is more common in boys than in girls. Many people with HSP had an upper respiratory illness in the previous weeks. Purpuric lesions are usually over the buttocks, lower legs, and elbows. Besides purpuric lesions, nephritis, angioedema, joint pains, abdominal pain, nausea, vomiting, diarrhea, and he-matochezia can be seen. The scrotum can also be affected in 13%-35% of cases (Ioannides and Turnock 2001). While the testis and/or scrotum can rarelybe involved, usually the scrotum is diffusely tender with erythema distributed all over the scrotum. Involvement of the scrotum by HSP is self-limiting and therefore treatment is primarily expectant. The exquisite pain experienced by boys with this syndrome can mislead the surgical team to suspect torsion; in HSP cases, this can be ruled out with a Doppler ultrasound (Ioannides and Turnock 2001).
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