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October 2010

Lower Extremity Purpura in a Woman With Psychosis—Diagnosis

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Arch Dermatol. 2010;146(10):1167-1172. doi:10.1001/archdermatol.2010.280-b

A punch biopsy revealed a sparse, focal, perifollicular, and perivascular lymphocytic inflammatory infiltrate. Extravasated erythrocytes were present in a perifollicular distribution (Figure 2), and there was overlying follicular hyperkeratosis. Deeper tissue sections showed a corkscrew-shaped hair shaft emanating from one follicle (Figure 3). Ascorbic acid levels were undetectable, confirming the diagnosis. Unfortunately, the patient ultimately refused all treatment and was subsequently lost to follow-up.

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