Pigmented purpuric dermatosis

    Article Contributors: 
    Sean Klepper M.D.
    Stephen Lyle, M.D., ...
    • Multiple synonyms: purpura pigmentosa chronica, pigmented purpura, pigmented purpuric dermatitis, chronic purpuric dermatitis
    • Four clinical presentations: purpura annularis telangiectoides of Majocchi (Majocchi's disease), progressive pigmentary dermatosis of Schamberg (Schamberg's disease), pigmented purpuric dermatitis of Gougerot and Blum, eczematid-like purpura of Doucas and Kapetanakis
    • Lichen aureus represents a chronic localized variant of PPD.

    Clinical Features:

     

    • Discrete purpuric macular lesions, usually limited to the lower extremities
    • The etiology is unknown, but venous stasis, drugs and contact hypersensitivity have been implicated as possible causes.

    Histologic Features:

    • Superficial perivascular lymphocytic infiltrate which tends to spill into the dermis away from blood vessels
    • The infiltrate may sometimes become more lichenoid, particularly in pigmented purpuric dermatitis of Gougerot and Blum.
    • Mild vascular damage including endothelial swelling and focal karyorrhectic debris ("lymphocytic vasculitis")
    • Red blood cell extravasation
    • The epidermis may be normal or may show spongiosis, focal parakeratosis, exocytosis and/or vacuolar change.
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    Cases associated with this book:

  • Pigmented purpuric dermatosis
    Author: Stephen Lyle, M.D., Ph.D.

    Conference: DermatopathologyConsultations.com Teaching Collection