Purpuric pityriasis rosea.

Abstract

A 17-year-old young man presented with a 2-week history of an asymptomatic widespread eruption affecting the trunk and arms. On physical examination we observed multiple, oval purpuric macules and papules, 1–3 cm in diameter, distributed in a “christmas tree” pattern on the trunk and arms (1, 2). There was no sign of a herald patch and mucosal examination was normal. Figure 1Open in figure viewerPowerPoint Lesions distributed in christmas tree pattern on the trunk Figure 2Open in figure viewerPowerPoint Purpuric macules and papules on the arm Laboratory tests including complete blood cell count, erythrocyte sedimentation rate, prothrombin time, partial thromboplastin time, biochemical and urinary analysis were all within normal limits. A biopsy specimen from a lesion of the left arm revealed superficial perivascular lymphohistiocytic infiltrate and erythrocyte extravasation, dermal edema, spongiosis and hypogranulosis (Fig. 3). Figure 3Open in figure viewerPowerPoint Histologic examination from the left arm. Superficial perivascular lymphohistiocytic infiltrate, erythrocyte extravasation and spongiosis. (hematoxylin and eosin, × 400) A diagnosis of purpuric pityriasis rosea was made based on clinical and histopathological findings. It was suggested the patient minimize sweating and bathing and follow-up without treatment. One month later the eruption cleared spontaneously without recurrence.