M. GRICHNIKJAMESMD, PhD
Different clinical forms of purpura are the result of either noninflammatory or inflammatory changes within or around the blood vessel walls. Dermoscopy helps in distinguishing between these forms beyond the standard examination. The basic dermoscopic patterns are (1) homogeneous, (2) mottled, (3) perifollicular (with purpuric halos), and (4) epidermal purpuric.1
The homogeneous purpuric pattern characterizes a noninflammatory form of purpura, such as bleeding diathesis (Figure 1shows the lesions on a patient with acenocoumarol overdose), or vessel wall or supporting stroma abnormalities, such as senile or steroid purpura (Figure 2). This pattern consists of wide, homogeneous, structureless purpuric areas.
ASHFAQ AM, ALON S, Vazquez-Lopez F, García-García B, Sanchez-Martin J, Argenziano G. Dermoscopic Patterns of Purpuric Lesions. Arch Dermatol. 2010;146(8):938. doi:10.1001/archdermatol.2010.162