Pigmented Purpuric Dermatosis: A Review of the Literature

Abstract

The pigmented purpuric dermatoses (PPDs) are a group of benign, chronic diseases. The variants described to date represent different clinical presentations of the same entity, all having similar histopathologic characteristics. We provide an overview of the most common PPDs and describe their clinical, dermatopathologic, and epiluminescence features. PPDs are both rare and benign, and this, together with an as yet poor understanding of the pathogenic mechanisms involved, means that no standardized treatments exist. We review the treatments described to date. However, because most of the descriptions are based on isolated cases or small series, there is insufficient evidence to support the use of any of these treatments as first-line therapy.

Pigmented purpuric dermatosis: Ten years of experience in a tertiary hospital and awareness of mycosis fungoides in differential diagnosis

“…Of 127, PPD diagnosis was confirmed in 87 patients (68.5%) and the remaining 40 (31.5%) had non‐PPD causes pathologically. Of the 40, we detected non‐specific examination findings in 12 (9.4%) patients, vasculitis in eight (6.2%), pityriasis rosea in six (4.7%), MF in five (3.9%), suspected‐MF in two (%), 1,5 and other dermatoses (stasis dermatitis, contact dermatitis, nummular dermatitis, parapsoriasis, and post‐lesional hyperpigmentation) in seven (5.5%) (Table 3). The biopsy results of two patients indicated PPD, but during follow‐up, these patients were diagnosed as MF.…”

“…The cause of PPD remains unclear, but its association and relationship with many diseases have been reported, including diabetes mellitus, rheumatoid arthritis, liver diseases, lupus erythematosus, lymphoid malignancies, and various drugs 1,6‐8 . Food and food additives, inhaler, and contact allergens were among the other factors associated 4 .…”

“…Schamberg disease, the most common form, often leads to petechiae with the salt‐and‐pepper appearance in both lower extremities. Lesions are mostly asymptomatic 1 . Histopathology shows superficial perivascular lymphocyte accumulation, extravasated erythrocytes, and hemosiderin‐containing macrophages.…”

“…The diagnosis is through clinical findings, histopathology, and exclusion of diseases in the differential diagnosis. Diseases such as senile purpura, contact eczema, stasis dermatitis, vasculitis, and purpuric mycosis fungoides (MF) should be considered in the differential diagnosis 1,3 . In this study, we aimed to reveal the demographic, clinical, and histopathological data of patients diagnosed with PPD and the frequency of diseases that can be considered in the differential diagnosis.…”

Saturday night purpura: An uncommon presentation of exercise‐induced vasculitis

“…In addition, Perls's stain demonstrates the presence of iron (hemosiderin) in the superficial dermis. Unlike EIV, leukocytoclasia is not observed in exercise‐induced capillaritis 7,8 …”