September 2021 - Case of the Month
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 26 year old man presented with a two week history of a slightly itchy rash on his shins. There was no other relevant skin history, or family history. The patient was otherwise well and took no medications. He had an office-based job.
Examination revealed irregularly distributed brown-orange patches with cayenne pepper spots on their borders. The lesions were non-palpable and affected no other body site.
What is the diagnosis?
The diagnosis is a pigmented purpuric dermatoses (syn. capillaritis)
The pigmented purpuric dermatoses are not uncommon, and represent a group of chronic skin conditions of mostly unknown aetiology that have a very distinctive clinical appearance. They are characterised by extravasation of erythrocytes in the skin with marked haemosiderin deposition, resulting in many tiny red lesions described as cayenne pepper spots, which group together to form brown-red patches, especially on the lower legs.
The most well described pigmented purpuric dermatoses is Schamberg disease.
Patients are otherwise well, and unlike in vasculitis there is no palpable purpura.
For more information click on the following link Pigmented purpuric dermatoses (syn. capillaritis)
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 52 year old man presented with a one year history of skin lesions predominantly on his hands, ears and scalp. He was also complaining of painful swollen fingers associated with morning stiffness. There was no family history of skin or joint problem...
A 72 year old man was referred with a rash, predominantly on the legs. The patient was systemically well and the lesions were only mildly symptomatic. The lesions presented as one to several at a time lasting several weeks. They had not res...
Welcome back to the new look PCDS website, and our first case. This lady was referred as a 2-week wait with a changing lesion on the right temple.
A 15 year old lady was referred for a diagnostic opinion for skin changes presenting in birth, affecting the right upper back, shoulder, antecubital fossa and dorsal wrist. The patient was asymptomatic and otherwise well.
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