• 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.

Cases associated with this book:

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

Conference: DermatopathologyConsultations.com Teaching Collection