Pigmented Purpuric Dermatoses
Gonzalo De Toro, MD
Key Facts
Clinical Issues
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More common in males, between 3rd-6th decade
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Usually bilateral purpuric lesions, on lower extremities (pretibial and on the ankles), but sometimes lower trunk and upper extremities
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PPD has different clinical presentations and denominations, but the same histological findings
Microscopic Pathology
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Main histologic finding is lymphocytic perivascular infiltrate limited to papillary dermis, which is sometimes between vessels, in a band-like or lichenoid pattern
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Extravasated red blood cells and often subtle hemosiderin deposits are found in vicinity of capillaries
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Vascular injury is usually minimal
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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
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Pigmented purpuric dermatoses (PPD)
Synonyms
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Capillaritis of unknown cause
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Purpura pigmentosa chronica
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Pigmented purpura
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Pigmented purpuric dermatitis
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Chronic purpuric dermatitis
Definitions
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Group of idiopathic disorders of unknown etiology characterized by petechiae and bronze discoloration of skin on lower extremities
CLINICAL ISSUES
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