Rumpel-Leede phenomenon in a hypertensive patient due to mechanical trauma: a case report.
BACKGROUND
In this report, we present an interesting case of a patient with Rumpel-Leede phenomenon, a rare occurrence that can result in significant delays in medical treatment. This phenomenon is characterized by the presence of a petechial rash that results from acute dermal capillary rupture. In our patient, it occurred secondary to raised pressure in the dermal vessels caused by repeated inflation of a sphygmomanometer cuff. Contributory factors in Rumpel-Leede phenomenon include prevalent conditions such as diabetes mellitus, hypertension, thrombocytopenia, chronic steroid use, antiplatelets, and anticoagulants.


METHODS
A 58-year-old Russian woman with diabetes and hypertension presented to our hospital with a non-ST elevation myocardial infarction, and she subsequently developed a petechial rash on her distal upper limbs. A vasculitic screen was performed, with normal results.


CONCLUSIONS
Given the timing and distribution of the rash, it was felt that this was an example of Rumpel-Leede phenomenon in a susceptible individual. This is an important diagnosis to be aware of in patients with vascular risk factors presenting for acute medical care who subsequently develop a petechial rash.
Department of Cardiology, Imperial College Healthcare NHS Trust, London, W12 0HS, UK. adamhartley@doctors.org.uk.
Adam
A
Hartley
Department of Cardiology, Imperial College Healthcare NHS Trust, London, W12 0HS, UK.
Phang B
PB
Lim
Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, West Midlands, UK.
Sajad A
SA
Hayat
D000925:Anticoagulants / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy; D001795:Blood Pressure Determination / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011693:Purpura / Q000209:etiology*; D012307:Risk Factors; D014859:Warfarin / Q000009:adverse effects*
D000925:Anticoagulants; D014859:Warfarin
Diabetes mellitus; Mechanical trauma; Petechial rash; Rumpel-Leede phenomenon