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2.1
Itching Purpura
Itching Purpura of Loewenthal

Presentation

[…] on varying clinical presentation: progressive... [dermatologyadvisor.com]

Older lesions tend to be less inflammated and extravasated RBC may no longer be found present at the affected area. [sydneyskinandvein.com.au]

Histologically, PPD presents with perivascular infiltrates of lymphocytes and macrophages centered around the superficial small blood vessels with narrowing of the lumina. [mdedge.com]

Other forms are rare and with an unusual presentation [1]. 2. [mdpi.com]

Gastrointestinal

  • Diarrhea

    These usually manifest with nausea, vomiting, diarrhea and anorexia. Congestive heart failure manifestations. Lung involvement leads to pneumonitis. Eye changes: retinal hemorrhage. [drmhijazy.com]

Skin

  • Dermatitis

    Khaki-colour clothing dermatitis and contact dermatitis to rubber are implicated. Lichen aureus - May also be known as Lichen Purpuricus. Usually occurs ranging from the 20s to 30s age gap. [sydneyskinandvein.com.au]

    […] is the most common PPD (Pigmented Purpuric Dermatitis). [jdrntruhs.org]

    Next Article: Contact Dermatitis [mdedge.com]

    Pigmented purpuric lichenoid dermatitis of Gougerot and Blum. (a–c). Purpuric red-brown lichenoid papules on lower extremities. Figure 4. Pigmented purpuric lichenoid dermatitis of Gougerot and Blum. (a–c). [mdpi.com]

    Pigmented purpuric lichenoid dermatitis of Gougerot and Blum - red/brown papules and plaques in men - which responds to psoralen combined with ultraviolet A (PUVA) treatment. [patient.info]

  • Urticaria

    Urticaria and purpura with multisystmes involvement of kidneys, bowel and joints characterize this type of purpura. Etiology Damage to the walls of small blood vessels due to deposition of immune-complex substances. [drmhijazy.com]

Workup

Other Pathologies

  • Lymphocytic Infiltrate

    The perivascular lymphocytic infiltrate of T cells is centered on the superficial dermal venules which show signs of endothelial swelling and narrowing of the lumen. [sydneyskinandvein.com.au]

    [Journal Article] J Cutan Pathol. 1979 Feb; 6(1):1-4.Duncan SC, Winkelmann RK JC The characteristic histologic change seen at 2 h in the Rumpel-Leede (Hess) test is, in addition to focal hemorrhage in the upper dermis, a perivascular lymphocyte infiltrate [unboundmedicine.com]

    infiltration, erythrocyte extravasations, and hemosiderin deposition.1,2 Cell-mediated immunity as well as immune complexes have been implicated in disease evolution.1 Clinically, PPD is distinguished based on history, blood counts, biopsy, and if necessary [dermatologyadvisor.com]

    […] macules, papules and patches Spongiosis Intense lymphocytic perivascular infiltration Neutrophils Table 3. [mdpi.com]

    These entities and their main characteristics are summarized in Table 3.Dermoscopy The most common dermoscopic finding is a diffuse coppery-red background that histopathologically corresponds to the lymphocytic dermal infiltrate, extravasated RBCs, and [actasdermo.org]

Treatment

[…] and no standardized treatments with proven effectiveness exist, the risks and benefits of any treatment should be carefully weighed up. [actasdermo.org]

Oral therapies used for treatment of pigmented purpuric dermatosis. Table 3. Oral therapies used for treatment of pigmented purpuric dermatosis. [mdpi.com]

Pigmented purpuric lichenoid dermatitis of Gougerot and Blum - red/brown papules and plaques in men - which responds to psoralen combined with ultraviolet A (PUVA) treatment. [patient.info]

Treatments include topical corticosteroids and topical vitamin C. [patientcareonline.com]

Treatment Treatment comprises rapid transfusion of fresh frozen plasma. [drmhijazy.com]

Prognosis

Cutaneous vasculitis update: diagnostic criteria, classification, epidemiology, etiology, pathogenesis, evaluation and prognosis. Am J Dermatopathol. 2005;27:504-528. Marks, JG, Miller JJ. Lookingbill and Marks’ Principles of Dermatology, 4th ed. [clinicaladvisor.com]

Etiology

Etiology In older children, purpura fulminans may have several causes. [drmhijazy.com]

The etiologies of these conditions of the pigmented purpuric dermatoses are unknown, but a common pathogenetic mechanism is suspected. [clinicaladvisor.com]

Testing for antinuclear antibodies, rheumatoid factor, anti-HBsAg antibody, and anti-hepatitis C virus antibody aids in excluding a rheumatologic or viral etiology. [dermatologyadvisor.com]

The etiology of PPD is unknown; however, important cofactors include venous hypertension, exercise and gravitational dependency, capillary fragility, focal infections, and chemical ingestions.1 Drugs are the most important provoking factors, including [mdedge.com]

The etiology of PPD remains unknown. However, past literature work has implicated a number of factors that may affect the appearance of the condition. These factors include venous hypertension, exercise and lower limbs dependence. [sydneyskinandvein.com.au]

Epidemiology

(Epidemiology) Schamberg's disease is rare and there are few epidemiological studies in the literature. Schamberg disease may affect all ages but commonly occurs in middle-aged to older men and less frequently in children[2]. [patient.info]

We report a case of GPPD and provide a thorough literature review focusing on epidemiology, clinical symptoms, and treatment.2-17 The eTable summarizes all reported cases of GPPD. [mdedge.com]

Cutaneous vasculitis update: diagnostic criteria, classification, epidemiology, etiology, pathogenesis, evaluation and prognosis. Am J Dermatopathol. 2005;27:504-528. Marks, JG, Miller JJ. Lookingbill and Marks’ Principles of Dermatology, 4th ed. [clinicaladvisor.com]

Epidemiology of varicose veins. World J Surg. 1986;10:898-902. 4. McCausland AM, Holmes F, Trotter AD Jr. Venous distensibility during the menstrual cycle. Am J Obstet Gynecol. 1963;86:640-645. 5. Barwin BN, Roddie IC. [patientcareonline.com]

[…] lichenoid dermatosis of Gougerot and Blum, lichen aureus (lichen purpuricus), and Majocchi disease (purpura annularis telangiectodes).1 Less common variants are granulomatous PPD, itching purpura of Loewenthal, linear PPD, transitory PPD, and familial PPD.2 Epidemiology [actasdermo.org]

Pathophysiology

Article Menu Font Type: Arial Georgia Verdana Open AccessReview 1 Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy 2 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 [mdpi.com]

Prevention

Other tried treatments include vitamin C supplements, laser therapy and wearing support hosiery to prevent venous stasis. There is no evidence of definite benefit of the former two. Immunosuppressants have also been used[6]. [patient.info]

Leg compression and avoiding long periods of standing are recommended to prevent associated venous stasis.1 Psoralen photochemotherapy has been shown to be successful in treating Schamberg disease, pigmented purpuric dermatosis of Gougerot-Blum, and lichen [dermatologyadvisor.com]

Treatment with colchicine dates back to the year 2000, which is low cost, effective yet prevents relapse but newer therapeutic modes with Advanced fluorescence technology (AFT) pulsed light therapy imparts favourable results, using a 570 mm handpiece [jdrntruhs.org]

Advise patients that treatment does not prevent the development of new spider telangiectases. References: REFERENCES:1. Robson A. The pathology of cutaneous T-cell lymphoma. Oncology (Williston Park). 2007;21(2, suppl 1):9-12. 2. [patientcareonline.com]

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