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Puzzling Purpuras: Tale of an Unusual Bruise
Puzzle out the cause of an unusual bruise on the ankle of a young boy in this slide show based on a true story.
An otherwise healthy 7-year-old boy has an odd "rash" on one ankle. The pediatric hematologist has ruled out a number of malignancies and bleeding disorders. The parents are very anxious to find out what's wrong. And now they bring him to you.In these slides, follow Dr Jonathan Schneider's typically cautious, consistently thorough process to puzzle out the cause of the unusual bruise.
References:
Recommended reading
âºTristani-Firouzi P, Meadows KP, Vanderhooft S. Pigmented purpuric eruptions of childhood: a series of cases and a review of the literature. Pediatr Dermatol. 2001;18:299-304
âºMagro CM, Schaefer JT, Crowson AN, Li J, Morrison C. Pigmented purpuric dermatosis: classification by phenotypic and molecular profiles. Am J Clin Pathol. 2007;128:218-229.
âºZvulunov A, Avinoach I, Hatskelzon L, et al. Pigmented purpuric dermatosis (Schamberg's purpura) in an infant. Dermatol Online J. 1999;5:2.
âºNagata K, Danno K, Tanaka S, Unilateral Schamberg disease in a 14-year-old Japanese boy. J Dermatol. 1999;26:348-351.
âºLasocki AL, Kelly RI. Narrowband UVB therapy as an effective treatment for Schamberg's disease. Australas J Dermatol. 2008;49:16-8 http://onlinelibrary.wiley.com/doi/10.1111/j.1440-0960.2007.00411.x/abstract
âºAiba S, Tagami H. Immunohistologic studies in Schamberg's disease. Evidence for cellular immune reaction in lesional skin. Arch Dermatol. 1988;124:1058–62. doi: 10.1001/archderm.124.7.1058.
âºNewton RC, Raimer SS. Pigmented purpuric eruptions. Dermatol Clin. 1985;3:165-9. http://www.ncbi.nlm.nih.gov/pubmed/4092379
âºAbeck D, Gross GE, Kuwert C, et al. Acetaminophen-induced progressive pigmentary purpura (Schamberg's disease). J Am Acad Dermatol, 1992;27:123-4
âºBaselga E, Drolet BA, Esterly NB. Purpura in infants and children. J Am Acad Dermatol. 997;37:673-705 http://www.ncbi.nlm.nih.gov/pubmed/?term=J+Am+Acade+Dermatol.+997%3B37%3A673-705
