Pigmented purpuric dermatosis and hepatitis profile: a report on 10 patients

Dessoukey, M. Wagdy; Abdel‐Dayem, Hussein M.; Omar, Mohamed F.; Al-Suweidi, Naeema E.

doi:10.1111/j.1365-4632.2005.02045.x

Cited by 15 publications

(7 citation statements)

References 23 publications

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“…In a report by Dessoukey et al, they proposed that the hepatitis virus may directly induce lymphocytic capillaritis through humoral or cell-mediated immune vessel reaction. 9 In our study, fibrinogen deposition was observed in six out of the seven patients with hepatitis infection; however, no statistically significant association was found between hepatitis infection and fibrinogen deposition. These findings suggest that hypertension, diabetes mellitus, and hepatitis infection may play a role in the development of fibrinogen deposition, inflammation, and red blood cell extravasation observed in PPD.…”

Section: Vascular Iga and Fibrinogen Deposition In Dif Usually Indica...contrasting

confidence: 69%

“…However, it has been linked to vascular problems such as venous hypertension, capillary fragility, stasis dermatitis, physical activity, and infections. [1][2][3][4]9 In this study, the most common deposition was fibrinogen, observed in 71% of patients. Fibrinogen is an acute-phase protein produced by the liver following bacterial infections, trauma, major surgeries, and chronic inflammatory diseases.…”

Section: Vascular Iga and Fibrinogen Deposition In Dif Usually Indica...mentioning

confidence: 47%

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A retrospective study on the direct immunofluorescence findings in pigmented purpuric dermatosis

Ilagan

2023

J Cutan Pathol

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BackgroundPigmented purpuric dermatosis (PPD) is characterized by grouped petechiae, purpuric macules, and pigmentation in the bilateral lower extremities. It runs a chronic and relapsing course. Pathophysiology is poorly understood, but it has been proposed to be an immune‐complex disease or capillaritis. This study aimed to determine the incidence and patterns of positive direct immunofluorescence (DIF) findings in patients with clinically and histopathologically confirmed PPD. The association between DIF deposition type and clinical profile was also analyzed.MethodsPatients with a clinical and histopathologic PPD diagnosis who had undergone DIF studies at a tertiary medical center with attached dermatopathology and immunofluorescence diagnostic centers between January 2002 and December 2021 were included in this study. Data on age, sex, disease duration, comorbidities, and drug intake were collected from medical records.ResultsThere were 65 patients who satisfied the inclusion criteria. Among them, 58 (89%) had at least one positive finding and 53 (82%) were vascular deposition of immunoglobulin (Ig), complement, or fibrinogen. The most common vascular deposition was fibrinogen (71%) followed by C3 (62%), IgM (18%), IgA (6%), and IgG (3%). Fibrinogen deposition was associated with hypertension (p < 0.03). There was no association between vascular DIF deposition of IgG, IgA, and C3, with age, sex, comorbidities, disease duration, and drug history.ConclusionThe most common DIF findings in PPD were vascular deposition of fibrinogen and C3, with or without Ig presence. DIF findings supported a vascular origin in PPD but not an immune complex‐mediated disease. Hypertension was associated with fibrinogen deposition and may play a role in its pathophysiology.

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Section: Vascular Iga and Fibrinogen Deposition In Dif Usually Indica...contrasting

confidence: 69%

Section: Vascular Iga and Fibrinogen Deposition In Dif Usually Indica...mentioning

confidence: 47%

A retrospective study on the direct immunofluorescence findings in pigmented purpuric dermatosis

Ilagan

2023

J Cutan Pathol

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“…The etiology of PPD is still much unknown, but venous hypertension, gravitational dependency, exercise, capillary fragility, alcohol ingestion, and focal infection were reported as highly likely to be potential causal or aggravating factors in PPD 7 8 9 10 . Some drugs had been suspected to occur with PPD, such as acetaminophen, aspirin, adalin, glipizide and hydralazine 11 12 13 14 15 16 17 18 19 20 21 22 . In fact, 48.3% of the subjects in this study had concomitant disease such as hypertension, diabetes mellitus, hyperlipidemia and cerebral infarction, but none of them reported that their medication was changed or started at the onset of the symptom.…”

Section: Discussionmentioning

confidence: 99%

Dermoscopic Findings and the Clinicopathologic Correlation of Pigmented Purpuric Dermatosis: A Retrospective Review of 60 Cases

Kim

Moon²,

Ryu

2021

Ann Dermatol

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Background Pigmented purpuric dermatosis (PPD) is known as a chronic recurrent eruption which usually presents with petechiae and pigmented macules on the lower extremities. Dermoscopy is a noninvasive diagnostic tool in identifying pigmented and vascular lesions, which can also be beneficial in the evaluation of PPD. Objective We aimed to analyze the common dermoscopic characteristics of PPD, and correlate those findings with the histopathologic features. Additionally, dermoscopic and pathological findings in this study population were compared with other similar studies from the literature review. Methods A retrospective analysis was performed using data of 60 patients who were diagnosed as PPD by skin biopsy and had dermoscopic examination. The pathologic analysis was performed by categorizing the pattern into lichenoid, perivascular, interface, and spongiotic subtype, and the dermoscopic assessment was performed by the three authors independently. Results In dermoscopy, 96.7% of the patients showed red globules and dots, followed by brownish patch, coppery-red pigmentation, and annular comma-like vessels. The pathologic pattern analysis revealed statistically significant association of lichenoid pattern with coppery red pigmentation, perivascular pattern with annular/comma-like vessels, and spongiosis pattern with reticular pigmented network and linear vessels. The interrater similarity test showed total kappa value of 0.811 which referred to “very good”. Conclusion In this study, the prevalence of dermoscopic features in Asian PPD patients was identified, which was similar with previous studies. The dermoscopic-pathologic correlation was found in four dermoscopic features. We suggest that dermoscopic examination is helpful in clinical diagnosis and pathological prediction of PPD.

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“…Some reports have suggested an association between PPD and hepatitis B or C infection 4 . While 5 patients were positive for HCV and 2 for HBsAg in a study involving 10 patients, in a case-control study, no statistically significant difference was observed in the prevalence of positive hepatitis B or C serological findings between the patients and controls 2 , 4 . In the present study, only 1 patient was positive for HBsAg and 1, for HCV.…”

Section: Discussionmentioning

confidence: 99%

“…There are very few clinical and etiological studies on PPD in the literature, as the disorder is rather uncommon 2 , 3 . A few case series on the relation between PPD and hepatitis B or C virus and hyperlipidemia have been reported 4 , 5 . PPD patients underwent patch testing only in 1 study, and this study did not have a control group 6 .…”

Section: Introductionmentioning

confidence: 99%

Clinical and Laboratory Findings of Pigmented Purpuric Dermatoses

et al. 2014

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BackgroundPigmented purpuric dermatoses (PPD) are chronic, recurrent group of disorders characterized by petechial and pigmentary macules usually localized on the lower limbs. Its etiopathogenesis is unknown. There are very few clinical and etiological studies on PPD in the literature.ObjectiveWe aim to examine the etiopathogenetic factors of PPD retrospectively.MethodsDemographic characteristics, history of co-morbid disorders and drug usage, hepatitis markers, levels of serum lipids, findings of Doppler ultrasonography in lower extremities, and patch test results of the 24 patients of PPD were examined retrospectively. The patch test results, history of drug use, and co-morbid disorders of the patients were compared with those of the control groups.ResultsThe male-to-female ratio was 1 : 2, and 83.3% of the patients had Schamberg disease. Seventeen patients had co-morbid disorders and 16 used various drugs, but there was no statistically significant difference between the controls and patients. One patient was positive for hepatitis B surface antigen and 1, for anti-hepatitis C virus antibody. Nine had elevated total cholesterol levels, and 5 had elevated triglyceride levels. Further, 30% of them were positive for at least 1 allergen, while 16% of the control subjects were positive for at least 1 allergen, but statistically significant difference was not found between the 2 groups. Variable degrees of venous insufficiency were detected in 75% of the patients on Doppler ultrasonography of the lower extremities.ConclusionVenous insufficiency and hypercholesterolemia might be the basic predisposing factors for PPD. Further studies are needed to show if diabetes mellitus and hypertension may cause perivascular inflammation in PPD.

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Pigmented purpuric dermatosis and hepatitis profile: a report on 10 patients

Abstract: Hepatitis C and B virus may play a role in the pathogenesis of pigmented purpuric dermatosis. Further case-control studies are necessary to confirm this conclusion.

Cited by 15 publications

References 23 publications

A retrospective study on the direct immunofluorescence findings in pigmented purpuric dermatosis

A retrospective study on the direct immunofluorescence findings in pigmented purpuric dermatosis

Dermoscopic Findings and the Clinicopathologic Correlation of Pigmented Purpuric Dermatosis: A Retrospective Review of 60 Cases

Clinical and Laboratory Findings of Pigmented Purpuric Dermatoses

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