Periodic painful purpura: Fact or factitious?

Vun, Yin; Muir, James

doi:10.1111/j.1440-0960.2004.00049.x

Cited by 18 publications

(17 citation statements)

References 19 publications

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“…These symptomatic therapy options have been met with varying outcomes but include corticosteroids, antihistamines, immunosuppressive drugs, and hormonal contraceptives. These treatments may provide symptom relief in patients, but they have not been shown to be effective in controlling GDS manifestations . Thus, therapy for the dermatological component may provide symptomatic management while in combination with disease modifying treatment for the psychological symptoms to provide the patient with the most optimal outcome.…”

Section: Discussionmentioning

confidence: 99%

Gardner‐Diamond syndrome: a systematic review of treatment options for a rare psychodermatological disorder

et al. 2018

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Gardner‐Diamond syndrome (GDS) is a rare psychodermatological condition characterized by the formation of spontaneous, painful skin lesions that develop into ecchymosis following episodes of severe physiological or psychological stress. The majority of GDS cases occur in young adult females, and although the etiology of this rare disorder is unknown, there appears to be a psychological component correlated with the coexistence of previous psychiatric diagnoses. Due to the rare nature of this disorder, there exist few guidelines for prompt clinical diagnosis and optimal treatment. Here, a systematic review was conducted to include 45 cases of patients with GDS to better understand clinical presentation as well as current treatment options. Ultimately, GDS is a diagnosis of exclusion after other coagulopathies and causes of purpura are ruled out. High clinical suspicion following laboratory and clinical exclusion of known physiological causes is necessary for diagnosis. Selective serotonin reuptake inhibitors (SSRIs) and corticosteroids are cost effective first line treatments for GDS with proven efficacy in symptomatic relief. GDS refractory to initial treatment may require regular psychotherapy and titrated SSRI dosages to achieve long‐term success. This review of available case studies serves to comprehensively describe the clinical presentation and available treatment approaches to this rare psychodermatological disorder.

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Section: Discussionmentioning

confidence: 99%

Gardner‐Diamond syndrome: a systematic review of treatment options for a rare psychodermatological disorder

et al. 2018

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“…The associated complaints in such patients also include neurological and ocular symptoms, hemorrhagic manifestations, menorrhagia, and a varied symptomatology. [9]…”

Section: Discussionmentioning

confidence: 99%

Antidepressant-induced Remission of Gardner Diamond Syndrome

Sawant¹,

Singh²

2012

Indian Journal of Psychological Medicine

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We describe the clinical presentation of a 25-year-old female patient who presented in dermatology with recurrent episodes of painful ecchymotic bruising over the anterior aspect of both arms and face. On enquiry, these episodes were precipitated by emotional stress and were preceded with a history of fall from the stairs. The patient also had multiple stressors in her day-to-day life and symptoms of depression. A diagnosis of mild depressive disorder without somatic complaints and Gardner Diamond syndrome was made. The patient was started on antidepressants, which not only improved her mood symptoms but also caused a remission of her painful bruises.

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“…Additional cases also showed the onset of autoerythrocyte sensitization could be preceded by surgical procedures or other forms of trauma [14]. Analogously, the correlation between the ecchymosis and acupuncture in the present patient created doubts with regards to a diagnosis of AES.…”

Section: Discussionmentioning

confidence: 66%

Autoerythrocyte Sensitization Syndrome Presenting with General Neurodermatitis: Factitious Purpura or Psychophysiological Entity?

Zhao

Luo

2012

Dermatol Ther (Heidelb)

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Autoerythrocyte sensitization syndrome (AES) is a disorder characterized by recurrent, spontaneous, painful bruising in patients with underlying psychosis and neurosis. Its pathogenesis is uncertain. Purpuric lesions reproduced by injections of washed autologous erythrocytes suggest an autoimmune etiology. The authors described a 50-year-old woman who presented with recurrent episodes of painful bruising for 8 months, along with a 2-year history of general chronic neurodermatitis. A diagnosis of AES was made on the basis of the clinical symptoms and laboratory examinations results: the positive autoerythrocyte sensitization test and psychophysiologic derangement. However, the noticeable symptoms, simultaneously identical distribution of the ecchymosis and neurodermatitis lesions, as well as concomitant symptom of itching over the ecchymosis, created doubts regarding the real etiopathogenesis of the ecchymosis and whether the ecchymosis in the present patient were just factitious purpura. The authors discuss the rarity of this case, which to the authors’ knowledge, had not been previously reported in the literature.

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Periodic painful purpura: Fact or factitious?

Cited by 18 publications

References 19 publications

Gardner‐Diamond syndrome: a systematic review of treatment options for a rare psychodermatological disorder

Gardner‐Diamond syndrome: a systematic review of treatment options for a rare psychodermatological disorder

Antidepressant-induced Remission of Gardner Diamond Syndrome

Autoerythrocyte Sensitization Syndrome Presenting with General Neurodermatitis: Factitious Purpura or Psychophysiological Entity?

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