An Unusual Presentation of Henoch-Schönlein Purpura With Penile Involvement in a 10-Year-Old Boy From Mexico.

Immunoglobulin A (IgA) vasculitis, also known as Henoch-Schönlein purpura, is the most common systemic vasculitis in childhood. It primarily affects the skin, joints, gastrointestinal tract, and kidneys. Extrarenal genitourinary manifestations are uncommon, and penile involvement is exceptionally rare, with very few cases documented worldwide and, to our knowledge, none previously reported in Mexico. A previously healthy 10-year-old boy presented with a purpuric rash on the extremities, arthralgia, abdominal pain, and progressive penile edema. Physical examination revealed pharyngeal hyperemia, palpable purpuric lesions on the extremities, an edematous and tender penis, and scrotal papules. Laboratory studies were unremarkable, with no evidence of infectious or autoimmune processes. Testicular ultrasound excluded torsion or other surgical causes. A clinical diagnosis of IgA vasculitis with penile involvement was made, and treatment was initiated with intravenous methylprednisolone followed by oral prednisone, achieving complete resolution without sequelae. Genital involvement in Henoch-Schönlein purpura is rare and may mimic surgical urological conditions. Early recognition of this presentation helps avoid unnecessary interventions. Doppler ultrasound and clinical correlation are essential for diagnosis. In the absence of severity criteria, corticosteroid therapy combined with local supportive measures is usually effective. This case represents the first report in Mexico of Henoch-Schönlein purpura with penile involvement. It highlights the importance of considering this entity in the differential diagnosis of pediatric acute scrotum and demonstrates the effectiveness of conservative management.