title: Purpuric generalized lichen nitidus: an unusual eruption simulating pigmented purpuric dermatosis.
abstract: BACKGROUND
  Generalized haemorrhagic lichen nitidus is rare. To our knowledge, this form of presentation has only been reported once.
  
  
  OBJECTIVE
  To describe a new case of generalized haemorrhagic lichen nitidus simulating a pigmented purpuric dermatosis.
  
  
  RESULTS
  We document a 24-year-old man who presented with an 8-month history of a progressive non-pruritic, red-brown papular eruption on the dorsa of the feet, ankles and distal third of the legs. A diagnosis of Schamberg's progressive pigmentary dermatosis was made, and no treatment was prescribed. Two months later, the lesions had extended to the abdomen, groins, forearms, elbows and wrists. Biopsy of the skin of the right foot revealed lesions typical of lichen nitidus with subepidermal extravasation of red cells and capillary wall hyalinization. Macrophages and T lymphocytes were abundant in the infiltrate.
  
  
  CONCLUSIONS
  Purpuric generalized lichen nitidus should be included in the differential diagnosis of pigmented purpuric dermatoses.
authors.affiliation: Dermatology Service, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria, Santander, Spain.
authors.forename: Sonsoles
authors.initials: S
authors.lastname: Yáñez
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Val-Bernal
mesh_terms: D000287:Administration, Topical; D000328:Adult; D001707:Biopsy, Needle; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007868:Leg Dermatoses / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D017513:Lichen Nitidus / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D010859:Pigmentation Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D011239:Prednisolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011693:Purpura / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D018570:Risk Assessment; D012720:Severity of Illness Index
chemical_list: D011239:Prednisolone; C035287:prednicarbate