Localized retiform purpura after accidental intra-arterial injection of polidocanol.

Sir, Non-inflammatory retiform (net-like or livedoid) purpura (NIRP) is a clinical pattern produced by small vessel occlusion in dermis. Several disorders such as coagulation abnormalities, cold-related gelling, microorganism vessel invasion or embolization leading to microvascular occlusion may share in common a clinical picture of localized or generalized NIRP (1). NIRP lesions are usually sharply demarcated and sometimes erythematous plaques, from a few millimetres to many centimetres in size, which subsequently become necrotic. The livedoid appearance can be diffuse or localized at the margins of large necrotic purpuric lesions. Early lesions tend to have minimal or no erythema, whereas in more advanced lesions, necrosis takes place. We report here a case of localized NIRP after intra-arterial injection of polidocanol during treatment for lower limb varicosities.