SELF ASSESSMENT ANSWERS Purple skin and a swollen thigh in an alcoholic

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Q1: How would you describe these skin lesions? What is the differential diagnoses? Figure 1 (see p 430) shows confluent ecchymosis in the background of icteric skin, mainly involving the left thigh. The differential diagnoses of non-palpable purpura/ ecchymosis include primary skin conditions (trauma, solar purpura, steroid purpura, capillaritis, and lividoid vasculitis), clotting disorders (thrombocytopenia, clotting factor deficiency, abnormal platelet function), conditions characterised by vascular fragility (amyloidosis, Ehlers-Danlos syndrome, and scurvy), conditions such as monoclonal cryoglobulinaemia, warfarin therapy, cholesterol and fat embolism, autoerythrocytic sensitivity, and Waldenstrom’s macroglobulinaemia.

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تاریخ انتشار 2002