Atypical presentation of Schamberg’s disease – diagnostic challenges

Introduction
Pigmented purpuric dermatoses (purpura simplex; inflammatory purpura without vasculitis) constitute a heterogenic group of inflammatory skin diseases.

Objective
To present a patient with extensive skin lesions secondary to pigmented purpuric dermatosis, Schamberg’s disease type.

Case report
A 34-year-old man patient was admitted to the Dermatology Clinic in Krakow, Poland, due to disseminated pigmented purpuric lesions. Schamberg’s disease was diagnosed on the basis of clinical, dermoscopic and histopathological examinations. The treatment involved preparations improving venous microcirculation, antihistamine drugs, and a series of UVB 311 treatment sessions – partial improvement was achieved.

Conclusions
An overview of literature and the presented case show that diagnosing pigmented purpuric dermatoses constitutes a challenge in everyday dermatological practice. The patients require a deepend diagnostic analysis and follow-up also because of possible coexistence or risk of future development of mycosis fungoides. Achieving a therapeutic effects is difficult. Treatment decisions are adjusted individually.