Pigmented purpura and cutaneous vascular occlusion syndromes

Abstract

Purpura is defined as a visible hemorrhage in the skin or mucosa, which is not evanescent upon pressure. Proper classification allows a better patient approach due to its multiple diagnoses. Purpuras can be categorized by size, morphology, and other characteristics. The course varies according to the etiology, as do the diagnostic approach and treatment. This review discusses pigmented purpuras and some cutaneous vascular occlusion syndromes.

Fulminans Purpura due to Morganella morganii

“…Severe acquired protein C deficiency and dysfunction of the protein C-thrombomodulin pathway and of other systems that exert a negative regulatory effect on coagulation have been implicated. However, a definite physiopathological mechanism has not been identified [5] . This report is the first publication to describe bacteraemia by M. morganii triggering a vasculitic response in the form of PF.…”

Purpura fulminans–like lesions in antiphospholipid syndrome with endothelial C3 deposition

“…8 Anticoagulation and antiplatelet drugs are administered in low-risk patients, and high-dose systemic steroids with anticoagulation, intravenous gamma-globulin, and plasma are administered in high-risk patients. 2 Therapy for dermatologic manifestations remains empirical and no treatment is systematically effective. Widespread cutaneous necrosis is considered a major thrombotic event requiring long-term anticoagulation treatment.…”

“…The condition affects the skin in 70% of cases, producing a variety of skin lesions. 2 Livedo reticularis is the most frequently observed lesion; other types of lesions include ulcerations, digital gangrene, subungual splinter hemorrhages, superficial venous thrombosis, thrombocytopenic purpura, pseudovasculitic manifestations, and primary anetoderma. Disseminated cutaneous necrosis with dermal vascular thrombosis 3 have been described on rare occasions.…”

Ecchymosis: A subtle sign unmasking malignancy

“…[ 1 ] It is classified as one of the subtypes of purpuric lesions alongside petechiae, macular purpura, palpable purpura, noninflammatory, and inflammatory retiform purpura. [ 2 ] Ecchymosis may occur due to blunt trauma or be physiological as in obese individuals. Pathological states predisposing to the development of ecchymosis include disorders of coagulation pathways and platelets in addition to disorders of dermal connective tissues.…”