Purpura factitia. An analysis of criteria for its differentiation from auto-erythrocyte sensitization purpura

Autoerythrocyte sensitization syndrome with positive anticardiolipin antibodies

“…There are three theories of pathogenesis; first, it may be a psychiatric condition, based on the high frequency of emotional and psychiatric features in these patients; 4 second, it may be self‐inflicted (purpura factitia), 5 although this is unlikely as the lesions in true factitial purpura lack an erythematous border and are not usually preceded by pain; third, it may be an immune disease, as suggested by Gardner and Diamond 1 . Positive responses to intradermal injection are reported with many agents and at sites distant from the injection of blood 3 .…”

Periodic painful purpura: Fact or factitious?

“…In purpura factitia, there is usually no ‘premonition’ before the development of lesions. The results of skin‐sensitivity tests tend to follow the patient's perception of their doctor's expectations, and be positive only if the injected areas are accessible to them 16 . Patients with AES are rarely free of lesions and continue to get lesions under plaster casts, while self‐inflicted lesions improve 1,15 , 17 .…”

Recurrent bruising with immunological abnormalities in a 24‐year‐old male traveller: a new entity?

“…Skin biopsies were similar with findings reported with traumatic ecchymoses and always excluded vasculitis involvement. In the reported case, specific features comprised the topography and the aspect of the lesions and the occurrence of recurrent bruising in a man, with marked immunological abnormalities and after having reasonably discarded all other causes of purpura 8 …”