Abstract
A 55-year-old woman with a recent history of metastatic breast cancer to bone presented with a purpuric rash on her jaw, neck, and chest (Fig 1). A hypercoagulability evaluation revealed an elevated activated partial thromboplastin time as well as lupus anticoagulant and anticardiolipin antibodies. The patient had no symptoms indicating infection. A lesional skin biopsy was performed and revealed ectatic, although not atypical, vascular spaces in the dermis, some of which were filled with clusters of cells in direct contact with the vessel walls (Fig 2, A).
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