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A child presented with a 6-month history of an asymptomatic, progressive rash. The rash started on her right lower calf and spread to her dorsal foot and superior thigh. Physical exam demonstrated brown-to-orange purpuric macules on her right lower extremity (figure 1). Laboratory tests including complete blood count (CBC) and antinuclear antibodies (ANA) were unremarkable. Skin biopsy revealed a superficial lymphocytic infiltrate and extravasated erythrocytes, consistent with pigmented purpuric dermatosis …
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