Teenage boy with bullous rash.

-A 14-year-old boy with recent antibiotic treatment for tonsillitis, presented to the emergency department with 1-week history of worsening rash and haemorrhagic bullae involving the bilateral legs, trunk and hands (figures 1 and 2). Laboratory results were significant for proteinuria (2+protein) and haematuria (1+, 5-10 red blood cells/high power field); 24 hours urinary protein and renal function were within normal limits. The patient had an inconclusive skin biopsy.edpract;106/6/352/F1F1F1Figure 1Left and right images show palpable purpura with some overlying bullae and vesiculation coalescing into plaques on both lower extremities.edpract;106/6/352/F2F2F2Figure 2Left image shows rash on abdominal wall and right image shows coalesced haemorrhagic bullae on hands. QUESTIONS: What is the most probable diagnosis?Bullous Ig A vasculitisMeningococcemiaBullous impetigoEosinophilic granulomatosis with polyangiitisCryoglobulinemiaWhat is the best test which will establish the diagnosis in this patient?Renal ultrasoundRenal biopsyAbdominal ultrasoundCreatinine clearanceWhat is first line of treatment in this patient?AntibioticsSteroidsSurgical debridementMultispecialty consultationImmunosuppressants such as azothioprineWhat other systems can this condition affect besides the skin?LungsKidneysSpleenNervous systemA, B and D Answers can be found on page 02.