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JAMA Dermatology Clinicopathological Challenge
January 2015

A Purpuric Patch on the Flank

Author Affiliations
  • 1Department of Dermatology, Georgetown University Hospital–Washington Hospital Center, Washington, DC
JAMA Dermatol. 2015;151(1):97-98. doi:10.1001/jamadermatol.2014.2721

A man in his 60s presented to the emergency department for left flank pain of 1 week’s duration. His medical history included severe peripheral arterial disease and a remote history of ruptured abdominal aortic aneurysm. Three months before presentation, he underwent percutaneous endovascular stenting of a left popliteal artery aneurysm. Physical examination of the left flank showed a well-defined 5 × 12-cm purpuric patch with a darker stellate patch within it (Figure, A). Two punch biopsy specimens were obtained (Figure, B and C).

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