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7-Year-Old Female with Rash on Legs

Can you diagnose this case?

Signs and Symptoms

A 7-year-old female presented for evaluation of an asymptomatic rash on her legs of a few days duration. She is otherwise healthy and denies any new exposures.

How would you treat this patient?

Choose one to reveal diagnosis and discussion

Just reassure the parents
Skin biopsy
Blood work for bleeding tendencies
Abdominal ultrasound of the abdomen
Start tetracycline class antibiotics

Answer: Just reassure the parents

See the full case at Consultant360

This patient has Majocchi’s purpura or benign pigmented purpura. This benign lymphocytic capillaritis is of unknown etiology and can appear alarming. A skin biopsy will confirm the diagnosis when the clinical diagnosis is uncertain. Both blood work for bleeding dyscrasias and an ultrasound to detect an enlarged spleen would be normal. Tetracycline class antibiotics are helpful to diagnose Rocky Mountain spotted fever or other tick born diseases. A topical steroid may hasten the healing process, but no treatment is necessary.