Purpura rhumatoïde révélateur d'un carcinome épidermoïde bronchique

Schoenlein-Henoch purpura is a systemic vasculitis involving the small vessels. In adults it is rare and is sometimes associated with malignancies such as bronchial carcinoma. We report the case of a 74-year-old male ex smoker who was admitted with necrotic skin lesions associated with a nephrotic syndrome, and was found to have a right upper lobe squamous cell bronchial carcinoma. The renal biopsy led to a diagnosis of IgA nephropathy related to Schoenlein-Henoch purpura. Curative surgical resection of the bronchial carcinoma (ypT2N0M0) was associated with remission of the purpura. The synchronous diagnosis of bronchial carcinoma and Schoenlein-Henoch purpura suggests a potential relationship between these two pathologies. Our observation and other published data strongly suggest a direct link on account of: the synchronous diagnosis, the clinical and biological remission of the Schoenlein-Henoch purpura after curative treatment of the bronchial carcinoma. It is important to recognise both the therapeutic and prognostic significance of this connection.