A healthy teenage girl presented with a history of a recurrent asymptomatic skin eruption. She had noted the gradual appearance of erythematous macules and reddish brown patches on her abdomen and lower extremities over a 1-month period. These areas would progressively fade to flesh tone or light brown during the winter and leave no scar. Similar macules and patches have recurred on an annual basis since the patient was 12 years old. She denied any history of preceding illness, prodromal symptoms, medication use, or easy bruisability. Her medical history and the results of the review of her symptoms were noncontributory.
Kim HJ, Skidmore RA, Woosley JT. Pigmented Purpura Over the Lower Extremities. Arch Dermatol. 1998;134(11):1477-1482. doi: