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September 1960


Arch Dermatol. 1960;82(3):468-475. doi:10.1001/archderm.1960.01580030162036

Diagnosis: Vasculitis. Presened by Douglas Torre, M.D.  A 45-year-old housewife "stubbed" her great toe about six months ago. Shortly thereafter, she noticed an erythematous, somewhat tender, plaquelike lesion on the plantar surface of the foot. Similar lesions then appeared on the leg, thigh, and buttock, and on the other lower extremity. In November, 1959, she was diagnosed as having polycythemia vera and has been treated by repeated phlebotomies.On the lower extremities are several plaquelike, erythematous, slightly infiltrated lesions, 7 to 12 cm. in size. The lesions on the plantar surfaces are tender. Some, but not all, of the erythema fades on diascopic pressure. A mild rosacea of the central oval of the face is present.

Biopsy Report.—  Only the superficial vessels (mostly capillaries) are involved. The vessels are thickened and some are occluded. Purpura is suspected. Perivascular reaction (lymphocytic) is minimal. Diagnosis: vasculitis (superficial). Majocchi?

Discussion  Dr. Sachs: I

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