• Vol. 48 No. 4
  • 15 April 2019

Painful Purpuric Ulcers of the Legs: A Tell-Tale Sign of Systemic Disease?

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A 71-year-old Chinese man presented with acute, painful
and progressive purpuric patches with haemorrhagic bullae
on the lower limbs. These lesions ulcerated and were
very slow to heal with eschar formation (Fig. 1). His past
medical history included hypertension. He denied any new
medications, contactants or illicit drug use. A skin punch
biopsy was taken from the foot lesion (Fig. 2). What is
your diagnosis?

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