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A Man With a Nonblanchable Purpuric Rash

20:00 EDT 12 Jun 2017 | JAMA

An older man presented with 4 weeks of diffuse rash and elbow and knee pain. The rash improved initially with prednisone but recurred at tapered dosing. Laboratory tests revealed normal blood cell counts, normal values for renal and hepatic panels, microscopic hematuria, and 1+ proteinuria. What would you do next?

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