22 - 143 - PIGMENTED PURPURIC DERMATOSES Flashcards
group of dermatoses that are characterized by petechiae, pigmentation, and, occasionally, telangiectasia
Pigmented purpuric eruptions (also called pigmented purpuric dermatoses [PPDs])
common histopathologic features of PPD
- superficial lymphocytic infiltrate
- erythrocyte extravasation
- hemosiderin deposition
most common of the PPDs to occur in children
PROGRESSIVE PIGMENTARY DERMATOSIS SCHAMBERG DISEASE
most common site of involvement of Schamberg Disease
lower extremities
“Cayenne pepper” appearance
PROGRESSIVE PIGMENTARY DERMATOSIS SCHAMBERG DISEASE
PURPURA ANNULARIS TELANGIECTODES MAJOCCHI PURPURA
- This subtype of PPD is characterized by its distinctive annular pattern
- Individual lesions begin as punctate telangiectatic macules that extend peripherally with central hypopigmentation or slight atrophy. 1 Lesions may be solitary or multiple in number. The lower extremities are the most common site of involvement and lesions can extend to involve the upper extremities and trunk.
- Majocchi purpura are generally asymptomatic and last several months with flares and remissions. As opposed to other subtypes of PPDs, Majocchi purpura presents most commonly in young adult females.
PIGMENTED PURPURIC LICHENOID DERMATOSIS OF GOUGEROT AND BLUM
This subtype is clinically distinguished by the presence of reddish-brown round or polygonal lichenoid papules and plaques, with a background of purpura or telangiectasias.
The term lichenoid describes this clinical appearance of lichenoid papules and plaques rather than the underlying histology.
ECZEMATIDLIKE PURPURA OF DOUCAS AND KAPETANAKIS
It is distinguished clinically by mild scaling overlying pinpoint erythematous macules and patches with associated pruritus.
This subtype spreads rapidly over a period of 15 to 30 days and will subsequently fade without treatment over several months to years, although recurrence is possible.
LICHEN AUREUS
As opposed to pigmented purpuric lichenoid dermatosis of Gougerot and Blum, where lichenoid refers to the clinical morphology of the lesions, in lichen aureus, lichen refers to both its clinical and histopathologic features.
It presents with more localized and persistent lesions with circumscribed macules or papules that are a distinctive gold, rust, or orange color.
presents acutely with widely disseminated orange-brown to purpuric lesions associated with severe pruritus
ITCHING PURPURA (DISSEMINATED PRURIGINOUS ANGIODERMATITIS)
The lesions first appear on the dorsal feet or lower extremities and then spread upward, sometimes with involvement of the trunk. Purpuric lesions are more apparent along the waistline, axilla, antecubital and popliteal fossae. Although this subtype of PPD has a chronic course, spontaneous remissions are possible.
This PPD is clinically distinguished by its linear or segmental distribution.
UNILATERAL LINEAR CAPILLARITIS (SEGMENTAL PIGMENTED PURPURA)
It tends to have a favorable prognosis, with spontaneous resolution occurring more commonly than in the other subtypes of PPDs.
Clinically, the lesions appear similar to other PPDs with purpuric and brown macules developing most commonly on the lower extremities and dorsal feet.
In addition to the classic histopathologic features of a PPD, a granulomatous infiltrate is present
GRANULOMATOUS PIGMENTED PURPURA
a relatively common disease association with granulomatous pigmented purpura
Hyperlipidemia
Drugs Implicated in Pigmented Purpuric Dermatoses
Implicated Causes of Pigmented Purpuric Dermatoses
