title: Early treatment with rutoside and ascorbic acid is highly effective for progressive pigmented purpuric dermatosis.
abstract: OBJECTIVE
  Progressive pigmented purpuric dermatosis (PPPD, Schamberg disease) is a rare benign, but chronic dermatosis frequently misdiagnosed as vasculitis or bleeding disorder. Although affected patients experience significant impairment in quality of life no effective treatment has been established. The aim of our two center case series was to evaluate efficacy and tolerability of the antioxidants rutoside and ascorbic acid as combination treatment for PPPD.
  
  
  METHODS
  A retrospective review was performed on 35 patients with PPPD treated with 2 × 50 mg rutoside and 1,000 mg ascorbic acid daily between 2004 until 2011. The mean treatment duration was 8.2 months.
  
  
  RESULTS
  71.4% of the participants experienced complete clearance and 20.0% an improvement of more than 50%, accompanied by increased quality of life. Nine participants (25.1%) relapsed after discontinuation. In seven, rutoside and ascorbic acid was re-initiated, and all responded again. Only three participants reported mild adverse effects. Participants with shorter disease duration showed better therapeutic success, shorter time to response and lower risk of recurrence.
  
  
  CONCLUSIONS
  Oral rutoside and ascorbic acid may be an efficient and well tolerated treatment for PPPD. Early treatment is recommended to achieve best clinical outcome.
authors.affiliation: Department of Dermatology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Schober
authors.forename: Wiebke K
authors.initials: WK
authors.lastname: Peitsch
authors.forename: Gisela
authors.initials: G
authors.lastname: Bonsmann
authors.forename: Dieter
authors.initials: D
authors.lastname: Metze
authors.forename: Kai
authors.initials: K
authors.lastname: Thomas
authors.forename: Tobias
authors.initials: T
authors.lastname: Goerge
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Luger
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Schneider
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000008:administration & dosage*; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010859:Pigmentation Disorders / Q000188:drug therapy* / Q000473:pathology*; D011693:Purpura / Q000188:drug therapy* / Q000473:pathology*; D012189:Retrospective Studies; D012431:Rutin / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012431:Rutin; D001205:Ascorbic Acid