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May 1977

latrogenic Traumatic Purpura Masquerading as Vasculitis

Arch Dermatol. 1977;113(5):689. doi:10.1001/archderm.1977.01640050149040

To the Editor.—  Palpable purpura suggests a number of disease states including necrotizing vasculitis, drug eruption, purpura fulminans, insect bite, and the progressive pigmented dermatoses. Histologically, an inflammatory infiltrate that is made up of either polymorphonuclear leukocytes or lymphocytes is often seen in a perivascular distribution. The following cases point out a further cause of palpable purpura that should be of particular interest to the hospital-based dermatologist.

Report of Cases.—Case 1.—  A 76-year-old man was brought to the emergency room complaining of the abrupt onset of left-sided weakness, accompanied by stool and urine incontinence. The patient was admitted. In-hospital physical examination demonstrated an elderly, alert man with mild hypertension and left-sided hemiparesis. In addition, there were multiple, slightly palpable, well-demarcated, grouped, violaceous, nonblanching, 0.5 × 0.5-cm lesions, with a central area of hemorrhage over both lower extremities; they were more frequent on the paretic extremity. The lesions were present over

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