Pigmented Purpuric Dermatoses
Gonzalo De Toro, MD
Key Facts
Clinical Issues
More common in males, between 3rd-6th decade
Usually bilateral purpuric lesions, on lower extremities (pretibial and on the ankles), but sometimes lower trunk and upper extremities
PPD has different clinical presentations and denominations, but the same histological findings
Microscopic Pathology
Main histologic finding is lymphocytic perivascular infiltrate limited to papillary dermis, which is sometimes between vessels, in a band-like or lichenoid pattern
Extravasated red blood cells and often subtle hemosiderin deposits are found in vicinity of capillaries
Vascular injury is usually minimal
 Schamberg disease clinically shows clusters of pinhead-sized red macules  and barely palpable papules. |
 Several clinical forms are shown in this image: Eczematid-like purpura of Doucas and Kapetanakis  , lichen aureus  , and Gougerot-Blum disease  . |
TERMINOLOGY
Abbreviations
Pigmented purpuric dermatoses (PPD)
Synonyms
Capillaritis of unknown cause
Purpura pigmentosa chronica
Pigmented purpura
Pigmented purpuric dermatitis
Chronic purpuric dermatitis
Definitions
Group of idiopathic disorders of unknown etiology characterized by petechiae and bronze discoloration of skin on lower extremities
