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. 2022 Feb;34(1):34-39.
doi: 10.5021/ad.2022.34.1.34. Epub 2022 Jan 27.

Venous Insufficiency is a Clear Provoker of Pigmented Purpuric Dermatosis

Hak-Jun Kim  1   2 , Gi-Wook Lee  1 , Jin-Wha Son  1   2 , Kihyuk Shin  1   2 , Hoon-Soo Kim  1 , Hyun-Chang Ko  1   2 , Byung-Soo Kim  1 , Moon-Bum Kim  1
Affiliations

Venous Insufficiency is a Clear Provoker of Pigmented Purpuric Dermatosis

Hak-Jun Kim et al. Ann Dermatol. 2022 Feb.

Abstract

Background: Pigmented purpuric dermatosis (PPD) is a chronic disorder characterized by distinct petechial hemorrhage and brownish pigmentation. The cause of PPD is unclear, but several underlying conditions are associated with it. Previous reports suggest that venous insufficiency (VI) might be related to PPD; however, a clear correlation remains unelucidated.

Objective: To elucidate the causal relationship between PPD and VI.

Methods: A total 118 patients diagnosed with PPD in the Department of Dermatology, Pusan National University Hospital from November 2006 to July 2019 were retrospectively reviewed. Doppler ultrasonography of the lower extremities was performed in 56 PPD patients, who were then divided into two groups: PPD with and without VI. We compared the clinical features between the two groups. In the PPD with VI group, we assessed the correspondence ratios between PPD and VI lateralities, and between the PPD distribution and the veins involved.

Results: VI was detected in 35 of the 56 patients (62.5%). The PPD with VI group was significantly associated with wider distribution, darker coloration and longer disease duration. There was a positive correlation of laterality between PPD and VI, and between PPD distribution and the vein involved.

Conclusion: This findings suggest that VI is a clear provoker of PPD.

Keywords: Doppler ultrasonography; Pigmentation disorders; Venous insufficiency.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Ascending routes of great saphenous vein (GSV) and short saphenous vein (SSV) in the lower extremities.
Fig. 2
Fig. 2. (A) In case of venous insufficiency in great saphenous vein (GSV), pigmented purpuric dermatosis (PPD) lesions were more likely to be distributed in the medial and anterior parts, which are in the GSV ascending route. (B) In case of short saphenous vein (SSV), PPD lesions were more likely to be distributed posterolaterally.
Fig. 3
Fig. 3. A 56-year-old female showing prominent improvement of pigmented purpuric dermatosis lesions after surgical correction of venous insufficiency (A: before surgical treatment; B: after surgical treatment).
See this image and copyright information in PMC

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