Purpuras

Figure 3.23
A: EAC
(Courtesy of Dr. Paul Getz)
B: Majocchi’s disease
(Courtesy of Dr. Sophie M.
Worobec)
C: Pigmented purpuric lichenoid
dermatitis
(Courtesy of Dr. Paul Getz)

Pigmented Purpuric Dermatosis (Figure 3.23B, C)

Group of dermatoses with capillaritis and petechial hemorrhages often in background of yellow discoloration due to hemosiderin deposition
Distribution/pattern varies according to specific variant
Histology: red cell extravasation, hemosiderin, perivascular lymphocytic infiltrate, ± lichenoid infiltrate in both lichen aureus and lichenoid dermatitis of Gougerot-Blum
Treatment: ascorbic acid + rutoside, ± phototherapy, compression stockings if accompanying venous stasis, topical corticosteroid if pruritus

	Variants		Description
	Schamberg’s disease (Progressive pigmentary dermatosis of Schamberg)		Discrete clusters of pinpoint erythematous nonblanching macules typically on lower legs → coalesce into patches with overall appearance of ‘cayenne pepper’; older lesions appear tan to brown
	Majocchi’s disease (Purpura annularis telangiectodes)		Annular erythematous plaques with punctate telangiectasias typically in young adults (more common in women)
	Pigmented purpuric lichenoid dermatitis of Gougerot and Blum		Lesions similar to Schamberg’s disease plus red-brown lichenoid papules and plaques
	Lichen aureus		Typically solitary rust to purple-colored patch or plaque on lower extremity with golden hue
	Eczematid-like purpura of Doucas and Kapetanakis		Scaly purpuric or petechial macules, patches and papules

Content

Purpuras