Pigmented Purpuric Dermatosis of the Hand: Clinicopathologic Analysis of Six Cases With Review of the Literature

Abstract

Pigmented purpuric dermatosis (PPD) is a group of skin disorders characterized by red, brown, or golden macules and patches with cayenne pepper-like spots. Classic histopathologic features include a perivascular lymphocytic infiltrate with associated erythrocyte extravasation and hemosiderin deposition. Although PPD most commonly affects the lower extremities, upper extremity involvement has been infrequently reported. Cases involving the hands are particularly rare. We present 6 new cases of PPD involving the hand and review 17 previously reported cases in the literature. All cases in our series were unilateral and localized to the dorsum of the hand. PPD was considered clinically in only 2 of these cases. Histopathologic examination revealed hallmark features of PPD, namely a superficial perivascular lymphocytic infiltrate and extravasated erythrocytes. Previous reports of PPD involving the hand described concurrent involvement of other anatomic sites in most cases; only 4 cases (24%) were confined to the hands. Histopathologic descriptions of these reported cases were compatible with PPD. In sum, our series describes a unique and rare clinical presentation of PPD confined to the unilateral dorsal hand. Because of the unusual presentation, biopsy is often required for accurate diagnosis.

Examining How Diet and Lifestyle Influence Skin Appearance Through a Common Risk Factor: Excess Iron—A Comprehensive Review

“…Sleep deprivation and UV exposure can exacerbate dark circles under the eyes, often partly due to hemoglobin deposits from leaking micro blood vessels [5]. Additionally, hemosiderin-a complex of hemoglobin and ferritin-contributes to various skin pigmentations [6], such as age spots and sunspots. Bruises represent another form of skin discoloration, resulting from blood pooling under the skin due to vessel damage, which leads to hemoglobin accumulation and visible discoloration [5].…”