Purpura and erythema associated with cutaneous numbness and hyperesthesia

Abstract

A 16-year-old healthy competitive female diver had blanching directly over her left anterior tibia and femur surrounded by purpura and erythema immediately after a missed dive from a 3-meter springboard (Fig 1). The athlete smacked with her left leg parallel to the water upon impact resulting in cutaneous numbness followed by hours of significant hyperesthesia. Question 1: What is the cause of this phenomenon? A. Allergic contact dermatitis from the chlorinated swimming pool B. Diving-related blanching with purpura C. Hot tub folliculitis D. Diving suit dermatitis E. Sunburn Answers: A. Allergic contact dermatitis from the chlorinated swimming pool e Incorrect. Chlorinated pool water can cause skin irritation, pruritus, and wheals, characteristic of contact dermatitis. B. Diving-related blanching with purpura e Correct. The unusual morphology of diving purpura is hypothesized to result from rapid compression of the soft tissue between the bone and the water