title: Granulomatous pigmented purpuric dermatosis.
abstract: The granulomatous variant of the pigmented purpuric dermatoses (PPDs) is a rare and infrequently described condition, with a total of 16 cases published to date. We report a case of granulomatous PPD in a 59-year-old white woman who demonstrated involvement of the arms, legs, chest and back with concurrent hyperlipidaemia. Histopathological examination revealed a lymphohistiocytic infiltrate obscuring the dermoepidermal junction, and loose granuloma formation in the superficial dermis, with extravasated erythrocytes. Other conditions within the differential diagnosis such as atypical infection, papular sarcoidosis and generalized granuloma annulare were excluded on clinical and histological grounds. Our patient represents the ninth patient reported to have granulomatous PPD with coexisting hyperlipidaemia, and the fifth patient with granulomatous PPD and a lichenoid infiltrate.
authors.affiliation: Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Battle
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Shalin
authors.affiliation: Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: L
authors.initials: L
authors.lastname: Gao
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006099:Granuloma / Q000473:pathology*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D008875:Middle Aged; D010859:Pigmentation Disorders / Q000473:pathology*; D011693:Purpura / Q000473:pathology*