a) allergic contact dermatitis _ _ _ _ _ _ _ _ _ _ Wrong answer ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

b) chronic pigmented purpuric dermatosis _ _ _ _ _ _ _ _ _ _ Correct ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

c) necrobiosis lipoidica diabeticorum _ _ _ _ _ _ _ _ _ _ Wrong answer ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

d) asteatotic eczema _ _ _ _ _ _ _ _ _ _ Wrong answer ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

e) leukocytoclastic vasculitis _ _ _ _ _ _ _ _ _ _ Wrong answer ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯

Answer and Commentary _ _ _ _ _ _ _ _ _ _ Chronic pigmented purpuric dermatosis is a common condition. Although commonly confined to the legs (Schamberg’s disease), it may be more widespread. The initial lesions are bright red spots of purpura. Later the hemosiderin gives the skin a golden brown color. The purpura is not palpable, helping to differentiate this from an allergic condition (leukocytoclastic vasculitis). The rash is usually asymptomatic but at times may be mildly pruritic. Biopsies show an inflammatory reaction around the superficial dermal capillaries a capillaritis. In the majority of cases there is no identifiable cause, but drugs (particularly carbromal) may be responsible for some cases. ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯ ¯