Microscopic examination showed dilated vessels throughout the dermis and subcutis, with intravascular collections of pale-pink homogeneous material and erythrocytes at the periphery of the vessel lumina. Despite vascular obstruction by these deposits, the overlying epidermis appeared viable. In the dermis, there was a sparse perivascular infiltrate of mixed inflammatory cells, scattered extravasated erythrocytes, and prominent edema. Stains for amyloid were negative. Microscopic findings were consistent with type I cryoglobulinemia. Evaluation of a serum sample revealed the presence of cryoglobulins. A computed tomographic scan of the thorax, abdomen, and pelvis demonstrated no abnormalities.
Purplish Papules on the Legs. Arch Dermatol. 2000;136(10):1263-1268. doi: