Itching Papules in a child; Scabies or Henoch Schonlein Purpura?

Henoch schonlein purpura (HSP) is a self-limited systemic disease with multiorgan involvement. While cutaneous involvement may wary, presenting as itching papules is not a common manifestation. In this report we discuss a case of HSP which was presented solely with itching papules; mistaken for scabies. A 7 year old boy presented with itchy palpable papules without any gastrointestinal or urinary problem which was primary taught to be an ectoparasitic infestation. During the hospitalization the patient developed abdominal pain as well as hematuria and the diagnosis became more evident. The skin biopsy showed perivascular inflammatory cells infiltration in epidermis, perivascular fibrinoid necrosis and leukocytoclastic vasculitis. The patient received corticosteroids and discharged healthy. While HSP may have different cutaneous manifestation, presenting as only itchy papules may complicate the diagnosis and physicians should always keep in mind that HSP might be presented as other common infestations unresponsive to treatment.