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|Ahead of print publication
Unilateral linear capillaritis
Piyush Kumar1, Chirag Desai2, Anupam Das3
1 Department of Dermatology, Katihar Medical College and Hospital, Katihar, Bihar, India
2 Divya Sparsh Skin and Hair Clinic, Mumbai, Maharashtra, India
3 Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
|Date of Submission||27-Dec-2019|
|Date of Decision||12-Mar-2020|
|Date of Acceptance||17-Apr-2020|
|Date of Web Publication||19-Sep-2020|
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Source of Support: None, Conflict of Interest: None
A 6-year-old otherwise healthy girl presented with gradually progressive asymptomatic hyperpigmented patches of bizarre shape, on the medial aspect of the left leg, present for the preceding 11 months [Figure 1] and [Figure 2]. There was no history of any bleeding disorder, and the rest of the medical and family history was non-contributory. There was no history of any trauma to the area or application of any drugs prior to the onset of the lesions. Dermoscopy showed linear vessels, brown reticular lines, red dots, and clods with a brown-pigmented network (Dermlite DL4, ×10, polarized light) [Figure 3]. Biopsy showed moderately dense superficial perivascular and interstitial infiltrate of lymphocytes and histiocytes. The papillary dermis showed a sparse deposition of hemosiderin. Numerous extravasated red blood cells were noted in the papillary dermis. Besides, few histiocytes showed intracellular deposition of hemosiderin [Figure 4]. A diagnosis of unilateral linear capillaritis was done and the parents were counseled regarding the benign nature of the disease.
|Figure 1: Bizarre shaped hyperpigmented patches on the medial aspect of the left leg|
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|Figure 3: Dermoscopy showing linear vessels, brown reticular lines, red dots and clods with a brown-pigmented network (Dermlite DL4, ×10, polarized light). [Black box- red dots and clods, yellow box- brown pigmentation, brown box- brown reticular lines and red arrow- linear telangiectatic vessels]|
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|Figure 4: Photomicrograph showing moderately dense superficial perivascular and interstitial infiltrate of lymphocytes and histiocytes (H and E, 100×)|
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Unilateral linear capillaritis is an uncommon but increasingly recognized variant of pigmented purpuric dermatoses. It was first described in 1992 by Riordan et al., as a benign inflammation of capillaries. Its striking clinical appearance along a dermatome on one limb clinches the diagnosis. On dermoscopy, red dots and clods correspond to extravasated blood, linear structures correspond to telangiectatic vessels and the brown pigmentation in the background represents hemosiderin. There is insufficient evidence to recommend a particular therapeutic option. However, counseling holds paramount importance, to avoid unnecessary treatment.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Riordan CA, Darley C, Markey AC, Murphy G, Wilkinson JD. Unilateral linear capillaritis. Clin Exp Dermatol 1992;17:182-5.
Ma HJ, Zhao G, Liu W, Dang YP, Li DG. Unilateral linear capillaritis: Two unusual Chinese cases. Eur J Dermatol 2007;17:160-3.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]