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Images in paediatrics
Pigmented purpuric dermatosis: a striking but benign cutaneous entity
  1. Hannah Song1,
  2. Johanna S Song1,2,
  3. Margaret Choy Merola1,3,
  4. Rosalynn M Nazarian1,3,
  5. Elena B Hawryluk1,2
  1. 1Department of Dermatology, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Elena B Hawryluk, Department of Dermatology, Massachusetts General Hospital, 50 Staniford Street, Boston, MA 02114, USA; Elena.hawryluk{at}

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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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  • Contributors HS wrote the first draft of the manuscript. JSS and EBH contributed to the critical revision of the manuscript. MCM and RMN obtained photographic documentation.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.