Blood Vessel Disorders

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Overview

There are several types of pigmented purpura, also called capillaritis, but the most common condition appears as pinhead-sized, reddish brown spots sprinkled in clusters on the skin, usually on the legs. The condition can fade away in a few weeks or months, or it can last years. To date, there is no effective treatment for pigmented purpura.

Causes

The cause (etiology) of pigmented purpura is generally unknown. There may be tiny blood vessel (capillary) fragility that allows red blood cells to escape into the skin. These eruptions can occur in young as well as older adults. Onset has been noted as a side effect of certain medication, as a reaction to certain foods, or due to a viral infection.

Signs and Symptoms

Typically, pigmented purpura appears as a brownish patch with a peppering of red dots, representing freshly extruded red blood cells, overall and at the lesion's edge. Discoloration is caused mostly by the escaped red blood cells depositing their iron molecules into the skin. The lesions can last for months to years. This condition is found most commonly on the legs and ankles but can appear on the thighs, arms, and trunk. Sometimes an eruption occurs on one side of the body. Some types of the condition are itchy or scaly.

Diagnosis

Diagnosis is made on the basis of observation. A skin biopsy can be obtained to exclude more serious conditions.

Treatment

Itching, if any, can be relieved with topical corticosteroids. Treatment has been attempted with antihistamines, vitamin C, aspirin, and support stockings. However, these have proven largely ineffective. If there is a possiblity that the condition is a side effect of a medication, discontinuing the medication (under the care of a physician) may help. If a certain food is suspected as a trigger, eliminating the food from the diet may help.

Prevention

There is no known prevention.

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