Pigmented Purpuric Dermatosis

Magro, Cynthia M.; Schaefer, Jochen T.; Crowson, A. Neil; Li, Jingwei; Morrison, Carl

doi:10.1309/aqmu3jfe2a66lc7e

Cited by 68 publications

(14 citation statements)

References 22 publications

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“…Epidermal spongiosis and exocytosis of lymphocytes are seen in all variants except lichen aureus. Lichenoid lymphocytic infiltration aids the differential diagnosis of PPD of Gougerot-Blum, and marked spongiosis and/or neutrophils are one of the features of eczematid-like purpura of Doucas-Kapetanakis 1 5 6 . Ackermann emphasizes that PPD is not a capillaritis, because fibrin is not present in the luminal wall and thrombi are not observed in the lumens.…”

Section: Discussionmentioning

confidence: 99%

“…Pigmented purpuric dermatosis (PPD) is a general term used to describe a group of chronic and relapsing cutaneous lesions. Such lesions are characterized by common petechiae and pigmentary macules of the skin that are primarily localized to the lower limbs; the histomorphologic features include superficial lymphocytic infiltration and marked hemosiderin deposition with erythrocyte extravasation 1 2 .…”

Section: Introductionmentioning

confidence: 99%

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Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis

et al. 2015

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BackgroundPigmented purpuric dermatoses (PPD) are a spectrum of disorders characterized by a distinct purpuric rash. Although PPD can be easily diagnosed, the disease entity remains an enigma and a therapeutic challenge.ObjectiveThe purpose of this study was to investigate the characteristics and clinical manifestations of PPD and to elucidate the relationship between assumed etiologic factors and the clinical manifestations of PPD and treatment responses.MethodsRetrograde analyses were performed to identify appropriate PPD patients who visited Korea University Medical Center Anam Hospital from 2002 to 2012.ResultsInformation on 113 patients with PPD was analyzed, and 38 subjects with skin biopsy were included for this study. Schamberg's disease was the most frequent clinical type (60.5%). Concomitant diseases included hypertension (15.8%), diabetes (10.5%), and others. Associated medication histories included statins (13.2%), beta blockers (10.5%), and others. Possibly associated etiologic factors were recent upper respiratory infection (5.3%), high orthostatic pressure due to prolonged standing (2.6%), and strenuous exercise (2.6%). A total of 36 patients (94.7%) were treated with one or more treatment methods, including oral antihistamines, pentoxifylline, topical steroids, and/or phototherapy. There was no significant difference in disease progress according to underlying diseases, medications, or association factors (p>0.05).ConclusionOur overall results were grossly consistent with the existing literature, excluding several findings. Although a possible relationship between PPD and cardiovascular disease or cardiovascular medication was proposed at the beginning of the study, no statistically significant correlations were found according to the specific clinical types and treatment responses (p>0.05).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis

et al. 2015

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“…A number of disorders have been found to be associated with PPD, such as DM, rheumatoid arthritis, lupus erythematous, thyroid dysfunction, hereditary spherocytosis, hematological disorders, hepatic disease, porphyria, and other malignancies 1 , 3 , 5 , 8 . In our study, 4 patients had DM, 3 patients, HT, and 2 patients, both DM and HT.…”

Section: Discussionmentioning

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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“…Clinically, MF has heterogeneous clinical manifestations, distinctive morphology, and its own histological findings. The average period of time between the initial manifestations and the time the diagnoss is finally made takes about 4–6 years . One variant of MF is hypochromic mycosis fungoides (HMF), which is more often diagnosed in nonwhite‐skinned people, probably because of its prominent characteristics .…”

Section: Introductionmentioning

confidence: 99%

Epidemiological, clinical, histological, and immunohistochemical study on hypopigmented epitheliotropic T‐cell dyscrasia and hypopigmented mycosis fungoides

et al. 2019

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Background Hypopigmented dermatoses, more evident in dark‐skinned people, are a frequent cause of consultation. Their etiology includes a wide range of dermatoses, from benign to malignant diseases. The clinical presentation appears very similar between them, making the correct diagnoses and management a challenge. Methodology Clinical records and histopathological biopsies were identified and compared in patients of the “Dr. Manuel Gea González” General Hospital throughout a 16‐year period with the presumptive diagnosis of hypopigmented epitheliotropic T‐cell dyscrasia (HTCD) or hypopigmented mycosis fungoides (HMF). Immunostaining analysis was performed in each specimen, the panel of antibodies used was: CD3, CD4, CD7, CD8, CD20, and CD62L. Results Thirty cases of 81 patients found in the registries were included in this study. The main age group was formed by children younger than 15 years old. The main clinical differences between both entities were gender, presence of plaques, and neck lesions. The most significant histopathological parameters used to differentiate both diagnoses were: severity of lymphocytic infiltration, the extent of epidermotropism, folliculotropism, presence of Pautrier's microabscesses, lymphocytes with cerebriform nuclei, and dermal fibroplasia. No immunohistochemical differences were found between them. Conclusion The clinical distinction between HTCD and HMF continues to be a challenge, therefore an extensive clinicopathological correlation must be performed. AbCD7 and AbCD62L were not useful to differentiate both dermatoses. This paper suggests that HTCD and HMF should be considered as the beginning and the end of the same clinical spectrum.

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Pigmented Purpuric Dermatosis

Cited by 68 publications

References 22 publications

Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis

Characteristics and Clinical Manifestations of Pigmented Purpuric Dermatosis

Clinical and Laboratory Findings of Pigmented Purpuric Dermatoses

Epidemiological, clinical, histological, and immunohistochemical study on hypopigmented epitheliotropic T‐cell dyscrasia and hypopigmented mycosis fungoides

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