The given clinical scenario and the image showing palpable purpura are suggestive of Henoch Schonlein purpura (HSP).

Henoch schonlein purpura is also known as IgA vasculitis. It is a small vessel vasculitis characterized by palpable purpura, arthralgias, gastrointestinal signs and symptoms, and glomerulonephritis.

Gastrointestinal manifestations are colicky abdominal pain, nausea, vomiting, diarrhea, constipation, and passage of blood in stools.

It is more commonly seen in children aged 4-7 years. Some of the factors that trigger the development of HSP include upper respiratory infections, drugs, foods, insect bites, and immunizations.

Skin biopsy is used to confirm the diagnosis by demonstrating the leukocytoclastic vasculitis with IgA and C3 deposition by immunofluorescence.

Henoch Schonlein purpura has an excellent prognosis. Patients with rapidly progressive glomerulonephritis are treated with glucocorticoids.

Other options:

Option A: Bechet's syndrome is characterized by recurrent genital ulcers, oral ulcers, skin lesions, eye lesions, or a positive pathergy test. Some of the patients have HLA B51 positivity. Oral ulcers are usually the first manifestation of the disease.
Option C: Microscopic polyangiitis affects small and medium-sized arteries with a predilection to involve the capillaries and venules Glomerulonephritis and hemoptysis due to alveolar hemorrhage can also occur.

Option D: Thrombotic Thrombocytopenic Purpura (TTP) is thrombotic microangiopathy that can be inherited or spontaneously acquired. It results from a deficiency of, or antibodies to, the metalloprotease ADAMTS13 which normally cleaves multimers of vWF. Failure to cleave these multimers results in excessive platelet adhesion and aggregation. It presents with the following pentad of clinical features:

Microangiopathic hemolytic anemia - mechanical shearing of RBCs as they pass through platelet rich-microthrombi
Thrombocytopenia - deposition of platelets in microthrombi
Renal failure - microthrombi in the renal vasculature
Neurologic findings - headache, confusion, transient focal neurologic deficits
Fever

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