A Case Report of Pigmented Purpuric Dermatosis With No Granuloma Formation: A 20‐year Follow‐Up Case Study

TL;DR

A 20-year case of pigmented purpuric dermatosis showed no granuloma formation despite long-term pigmentation and hyperlipidemia.

Contribution

The study highlights that granuloma absence may relate to histiocyte/phagocyte function, not disease duration or pigmentation.

Findings

Oral ozone water cured the primary disease but not the pigmentation.

Histological analysis showed no granuloma formation despite long-term pigmentation.

Hyperlipidemia did not influence granuloma formation in this case.

Abstract

In a case of pigmented purpuric dermatosis with hyperlipidemia reported earlier to be persistent for over 20 years, the primary disease was cured by oral rinsing with ozone water; however, the remaining prominent pigmentation was not remarkably improved even with oral administration of vitamin C and laser treatment. A histological examination of the lesion was performed to resolve the difficulty in removing this pigmentation. No granuloma reaction, including giant cells, was observed in the lesion tissue, even after such a long course and significant pigmentation. Granuloma formation in this disease may be a functional problem of the patient′s histiocytes and/or phagocytes rather than its chronic course or excessive hemosiderin deposition. Similarly, hyperlipidemia did not affect granuloma formation.

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