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.
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.