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June 1990

A Peculiar Purple Bruise

Author Affiliations

USA; USA Fitzsimons Army Medical Center, Aurora, Colo

Arch Dermatol. 1990;126(6):819-820. doi:10.1001/archderm.1990.01670300119023

REPORT OF A CASE  A 63-year-old man was referred to the dermatology clinic for evaluation of a "peculiar bruise" on his left thigh. The patient had well-controlled insulin-dependent (20 U of insulin suspension, isophane, each morning) diabetes. He had been in good health until 4 PM the preceding day, when he noted a small blister on the medial aspect of his thigh. There was no history of trauma or insect bite. The lesion rapidly enlarged over the next few hours. The patient developed nausea and malaise that evening, but no chills, fever, or vomiting.Ten hours after the onset of the lesion the patient went to the emergency department, where he was noted to have a large bruise. Results of laboratory tests performed during this visit were as follows: hemoglobin level, 141 g/L; hematocrit, 0.42; and white blood cell count, 16.0 × 109/L, with 0.60 neutrophils, 0.31 band cells

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