Persistent erythematous rash: a case study on the diagnosis and management of Schamberg disease

A 59-year-old woman presented with a persistent, nonpruritic erythematous rash on both lower extremities. Dermoscopy showed petechiae and hemosiderin deposition, and biopsy revealed perivascular lymphocytic infiltration with red blood cell extravasation, confirming Schamberg disease. Laboratory studies were unremarkable. Minimal improvement with topical corticosteroids prompted addition of oral rutoside, ascorbic acid, and pentoxifylline, resulting in gradual fading of lesions. Schamberg disease is a benign, chronic pigmented purpuric dermatosis that can mimic vasculitis. Diagnosis requires clinical and histologic correlation, and management focuses on cosmetic improvement and patient reassurance regarding its nonprogressive nature.