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Unknown: Lower extremity papules associated with easy bruising

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Unknown: Lower extremity papules associated with easy bruising
Jamie L Frey MD, James M Shehan MD
Dermatology Online Journal 14 (6): 19

Division of Dermatology, Department of Internal Medicine, Creighton University, Medical Center, Omaha, Nebraska.

Clinical synopsis

A 42-year-old female had a 2-month history of scattered, purple, asymptomatic papules predominantly on her lower extremities associated with easy bruising. The patient's history included multiple medical co-morbidities, including osteoporosis and a recent ankle fracture. Cutaneous small vessel vasculitis was suspected, so she was referred to our clinic for further evaluation. On examination, the lesions were noted to be perifollicular purpuric papules (Fig. 1). Hairs emerging from many of the hair follicles were slightly curly although the area had recently been shaved (Fig. 2). Further examination was unremarkable except for poor oral hygiene.

Figure 1 Figure 2
Figure 1. Purple papules on the leg.
Figure 2. Close-up image.

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