PMC9356192_01
Clinical and histopathological findings. a) Purpuric plaques characterized by hemorrhagic bullae, ulceration, necrosis, and diffuse edema on the left pelvic limb. b) and c) Biopsy sections of the patient's left thigh and left foot dorsum observed by electron microscopy. b) Dermoepidermal infarction with detachment of the superficial layer of the epidermis. c) Purpuric dermatitis associated with nascent thrombi in the deep vascular plexus.
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During initial assessment, abnormal vital signs, such as, tachycardia, arterial hypotension, and undetectable oxygen saturation were found; physical examination highlighted a localized bilateral and symmetric dermatosis of the lower extremities constituted by edematous purpuric plaques with tense blisters of bloody content, excoriations, areas of necrosis and hyaline exudate ( Fig. 1).