retiform purpura

Etiology

• vasculitis
  • rheumatoid arthritis
  • polyarteritis nodosa
  • granulomatosis with polyangiitis
  • eosinophilic granulomatosis with polyangiitis
  • systemic lupus erythematosus
  • cyroglobulinemia
  • scleroderma
• thrombosis
  • disseminated intravascular coagulation
  • thrombotic thrombocytopenic purpura/hemolytic uremic syndrome
  • antiphospholipid antibody syndrome
  • thrombophilia
  • myeloproliferative disorders
• embolism
  • fat emboli
  • cholesterol emboli after intravascular procedure
  • septic emboli
  • endocarditis
  • atrial myxoma
• calciphylaxis
• infection
  • meningococcemia
  • angioinvasive mycoses
  • ecthyma gangrenosum
  • necrotizing fasciitis
• pharmaceuticals
  • heparin
  • warfarin
  • levamisole-adulterated cocaine

Pathology

• total occlusion of cutaneous arterioles with resultant necrosis & hemorrhage in the watershed area of the artery
• occlusion of adjacent vessels may result in purpura & necrosis, especially of digits, ears, genitals

Clinical manifestations

• retiform purpura describes the netlike configuration of leakage from the skin vasculature

Diagnostic procedures

• skin biopsy

Management

• consider thrombotic & embolic causes 1st

More general terms

• purpura; retiform purpura