Capillary Alterations in Pigmented Purpuric Disease of the Skin

Abstract

Of the numerous diseases with purpuric manifestations, pigmented purpuric disease of the skin is of particular interest to the dermatologist, since there are usually no associated hematologic defects and arterial or venous insufficiency does not appear to be related to the eruption. There are three described entities which can be grouped together as pigmented purpuric disease because of their many similarities.¹ This group includes purpura annularis telangiectodes (Majocchi), peculiar progressive pigmentary disease (Schamberg), and pigmented purpuric lichenoid dermatitis (Gougerot and Blum). All three have in common the appearance of minute red puncta in the skin as the primary lesion. In addition, they are characterized by their usual location on the lower extremities and the occurrence of purpura and hemosiderin deposition in the skin. The criteria by which pigmented purpuric disease is subdivided consist of differences in the clinical appearance that can be regarded