Pigmented purpuric dermatosis: A dermoscopic and management perspective

Pigmented purpuric dermatosis (PPD) is an acquired chronic relapsing skin condition. It is characterized by asymptomatic or itchy symmetric petechiae, macules, and red-brown patchy pigmentation. The most common age group is between 4 th and 5 th decades of life. The most common site is the lower limbs. It is divided into 6 types: Progressive pigmentary dermatosis (Schamberg disease, pigmented purpuric lichenoid dermatitis of Gougerot and Blum, purpura annularis telangiectodes (Majocchi purpura), lichen aureus, eczematid-like purpura of Doucas and Kapetanakis, and itching purpura). The dermoscopic features of PPD are well established. They include red dots and globules, coppery red pigmentation, brown patches, brown dots, red patches, linear vessels, annular/comma-like vessels, and lentigines-like reticular pigmentation. Main histopathological features include superficial perivascular lymphocytic and histiocytic infiltration with marked hemosiderin deposition and no leukocytoclastic vasculitis. As there is no standardized treatment, various methods with varying efficacy are employed. This article presents a dermoscopic and management perspective of PPD and reviews the current literature related to this entity.