Recurrent Hemorrhagic Purpura of the Legs with Ulcer Formation. Presented by Dr. Max Wolf.
Ten months ago, reddish spots appeared on both lower extremities of a 27-year-old woman three weeks after a severe sore throat. They were accompanied by swelling of the ankles and severe pain in both knee joints. In the following month the reddish puncta enlarged, their color darkened, and their centers became vesicular, crusted, and finally ulcerated. It took five months for the ulcerations to heal. During this time the patient attended medical, dermatologic, and arthritic clinics. She was discharged with the diagnosis of "rheumatoid arthritis" and was advised to continue to take aspirin, which she did, in amounts of 10 to 12 tablets daily. Four months ago, the patient complained again of sore throat and earache. Three weeks later the second attack of her skin disorder started with reddish spots first on one