PMC3975201_01
Clinical photographs of the patient at initial presentation. Lateral view showing a purpuric eruption of the face and neck, with sparing of the submental V-shaped area.
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F1
Physical examination revealed non-palpable petechial purpura distributed on the face and extending to the neck (fig. 1).
A 5-mm punch biopsy specimen of the skin. Histopathological analysis showing mild perivascular lymphocytic infiltrates of the superficial dermis and erythrocyte extravasation. a HE, original magnification x100; b HE, original magnification x400.
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F2
HIV, HBV, HCV, CMV, EBV and PVB19 were all negative. Histopathological examination of the purpuric macules showed extravasation of erythrocytes and a slight lymphohistiocytic perivascular inflammation in the superficial and mid dermis, without evidence of vasculitis (fig. 2).
Photographs of the clinical evolution 2 months after the initial presentation. The clinical photographs show an intensification of the purpuric eruption of the face (a) as well as an extension of the purpura to the upper chest (b) and legs (c).
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F3
Two months later, the patient complained of night sweats and the purpuric eruption had extended to the whole body (fig. 3).