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progressive pigmentary dermatosis; Schamberg's purpura; pigmented purpuric dermatosis; purpura annularis telangiectodes of Majocchi; cutaneous T-cell lymphoid dyscrasia; capillaritis (CTLD)
Etiology:
- unknown
- venous hypertension, lack of exercise, & gravitational dependency are cofactors
Epidemiology:
- uncommon in children
Pathology:
- benign disorder
- leaky capillaries
- perivascular T-cell lymphocytic infiltrate centered on superficial small blood vessels of the skin
- signs of endothelial cell swelling & narrowing of the lumen
- extravasation of red blood cells with marked hemosiderin deposition in macrophages
* histopathology images [3]
Clinical manifestations:
1) progressive pigmented purpura
2) cutaneous petechiae & bronze discolorations located predominantly on the leg, with many clinical variations
3) lower extremities affected in all cases
4) lesions may improve in 1/4-1/3 of patients with 1-6 years
* images [3,5]
Laboratory: normal
Complications:
- development of cutaneous T-cell lymphoma
Management:
- no treatment indicated
General
purpura; retiform purpura
pigmentation disorder
References
- Draelos ZK, Hansen RC.
Schamberg's purpura in children: case study and literature
review.
Clin Pediatr (Phila). 1987 Dec;26(12):659-61. Review.
PMID: 3315387
- Torrelo A, Requena C, Mediero IG, Zambrano A.
Schamberg's purpura in children: a review of 13 cases.
J Am Acad Dermatol. 2003 Jan;48(1):31-3.
PMID: 12522367
- Mehregan D, Elston DM (images)
eMedicine: Pigmented Purpuric Dermatitis
http://emedicine.medscape.com/article/1084594-overview
- Magro CM et al.
Pigmented purpuric dermatosis: Classification by phenotypic
and molecular profiles.
Am J Clin Pathol 2007 Aug; 128:218
PMID: 17638655
- DermNet NZ. Capillaritis (images)
http://www.dermnetnz.org/vascular/capillaritis.html