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.
- 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.
- 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.