Pigmented Purpuric Dermatosis in Children: A Systematic Review

Background: Pigmented purpuric dermatosis (PPD) is a dermatological condition observed infrequently in the pediatric population. Due to its varied and rare presentation in children, it can be perplexing to dermatologists. Clinically, the morphology of PPD in children is identical to that in adults, manifesting as pigmented macules that range from brown to erythematous and occasionally violaceous or purpuric spots. Although the lower extremities are the most common presentation site, diffuse involvement can occur, albeit rarely. Both among adults and children, the most prevalent variants described are Schamberg disease and lichen aureus. There is limited literature on PPD in children, mostly consisting of isolated case reports and case series. The pathogenetic basis of the disease is not fully elucidated in children. Varied manifestations of the disease cause concern and are resistant to treatment. There is a need for further research on this entity. Methodology: We conducted a systematic review of PPD cases in search engines such as PubMed and ScienceDirect using the MeSH terms “Pigmented Purpuric Dermatosis” OR “Schamberg Disease,” AND “Childhood,” OR “Paediatric” till February 28, 2025. Results: The most common variant of PPD in children was found to be Schamberg’s purpura. The median age of presentation was 8.82 ± 4.53 years, with a sex ratio of 1:1 male to female. The mean duration of the disease was 22.86 ± 23.67 months, with a median of 12 months. Mostly, the disease was diagnosed clinically, dermoscopically, or histopathologically. Conclusion: This review examined the clinical presentation, diagnostic methods, and management options for childhood PPD.