Indian Dermatology Online Journal

THROUGH THE DERMOSCOPE
Year
: 2016  |  Volume : 7  |  Issue : 6  |  Page : 563--564

Dermoscopic pattern in a case of suction purpura over the face


Feroze Kaliyadan 
 Department of Dermatology, College of Medicine, King Faisal University, Al Hasa, Kingdom of Saudi Arabia

Correspondence Address:
Feroze Kaliyadan
Faculty of Dermatology, College of Medicine, King Faisal University, Al-Hasa Campus, Al Hasa
Kingdom of Saudi Arabia




How to cite this article:
Kaliyadan F. Dermoscopic pattern in a case of suction purpura over the face.Indian Dermatol Online J 2016;7:563-564


How to cite this URL:
Kaliyadan F. Dermoscopic pattern in a case of suction purpura over the face. Indian Dermatol Online J [serial online] 2016 [cited 2020 Jul 14 ];7:563-564
Available from: http://www.idoj.in/text.asp?2016/7/6/563/193902


Full Text

A 6-year-old child presented with a history of reddish discoloration of 2 days duration in the areaa bove the upper lip [Figure 1]. The child was otherwise healthy and there was no history of any other relevant skin or systemic disease in the patient or in the family. The child initially denied any history of trauma to the area. The parents of the child also did not give any other relevant history related to trauma or recent contact with any external agents such as paints or chemicals.{Figure 1}

On clinical examination, an ill-defined area of erythema was seen in the area above the upper lip. The lesions did not blanch on diascopy.

Dermoscopy (DermliteFoto II pro, attached to a Canon 650D digital SLR, polarized light ×10) revealed an irregular purplish purpuric pattern along the normal pseudonetwork pattern seen over the facial skin [Figure 2]. On further evaluation of the case history in light of the diascopy and dermoscopy findings, the child mentioned that she induced suction over the area while playing with a plastic water bottle. Hence, a diagnosis of suction purpura was made. Routine investigations including bleeding time, clotting time, platelet count, and liver function were within normal limits. The patient was followed up after 1 week and the lesions had subsided completely.{Figure 2}

Suction purpura is a type of purpura induced by mechanical causes involving suction. It is commonly seen in children and can be caused by a variety of things such as suction toys, vacuum extractors/cleaners, gas masks, therapeutic cups, and even sucking while kissing.[1]

Different patterns have been described in the dermoscopy of purpuric lesions.[2] Homogenous patterns are usually seen in bleeding diathesis, whereas, mottled patterns indicate an underlying inflammatory component such as vasculitis. Mottled patterns are associated with multiple small, speckled, purpuric splotches, and globules over a purplish background (the background later changes to an orange-brown color). The perifollicular pattern (along with other features such as corkscrew hairs) is typically seen in scurvy. To the best of our knowledge, the pattern of purpuric lesions in the pseudonetwork pattern over the face in a case of suction purpura has not been described before. While it is difficult to ascertain the reason for this particular pattern without proper histopathological correlation, we assume that the purpura remains very superficial and hence the follicular areas are not involved, thereby following the pseudonetwork pattern. This case also highlights that dermoscopy can be a useful tool in the diagnosis of purpura, especially when the lesions are not very clear on clinical examination.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Gupta LK, Khare AK, Pargi S, Mittal A. Suctionpurpura. Indian Dermatol Online J 2014;5:231.
2Vazquez-Lopez F, García-García B, Sanchez-Martin J, Argenziano G. Dermoscopic patterns of purpuric lesions. Arch Dermatol 2010;146:938.