PMC5225281_01
Retiform purpuric patch on the lumbosacral area occurring 1 day after lumbar puncture.
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The dermatology department was consulted for a new-onset retiform purpuric patch on the lumbosacral area that developed 1 day after the lumbar puncture (Fig 1).
A, Hematoxylin-eosin stain shows pauci-inflammatory thrombotic vasculopathy involving the capillaries and venules with concomitant ischemic necrosis of the epidermis. B, Deposits of C5b-9 within the microvasculature are seen using a diaminobenzidine technique on paraffin-embedded, formalin-fixed tissue, indicative of vascular complement activation.
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Histopathology found pauci-inflammatory thrombogenic vasculopathy affecting capillaries and venules throughout the dermis and subcutaneous fat with endothelial necrosis and sloughing into vascular lumens (Fig 2).
Necrosis of the retiform plaque observed 1 week after presentation.
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The affected site was treated with mupirocin ointment followed by white petrolatum impregnated gauze and nonadhesive dressings (Fig 3).