PURPLE (ATROPHIC BLANCHE) - CLINICAL, HISTOLOGICAL AND IMMUNOLOGICAL STUDY OF 12 PATIENTS

Objectives To investigate clinical, serologic, histopathologic and imm unopathologic markers of PURPLE (painful purpuric ulcers with reticula r pattern of lower extremities) or atrophie blanche. Design Twelve con secutive patients affected with idiopathic PURPLE were studied in the period 1992-1996. Patients with systemic diseases correlated to PURPLE were excluded from the study. Subjects All twelve patients were hospi talized at the Istituto Dermopatico Immacolata in Rome. Results Variou s and dishomogeneous immunological alterations were detected, Circulat ing immune complexes, increased serum levels of anticardiolipin and an tinuclear antibodies, reduced serum complement levels, and deposition of immunoreactants in dermal vessels, were found in a limited number o f patients. The results were not statistically significant. All the pa tients showed very similar histopathological aspects, characterized by microvascular thromboses, endothelial swelling and segmental hyaliniz ation of small dermal vessels. Conclusion PURPLE is a thrombogenic vas culopathy in which unspecified immunological and laboratory changes ar e present. The recently suggested pathogenetic role of anticardiolipin and protein C deficiency in the disorder is not confirmed by this stu dy. (C) 1997 Elsevier Science B.V.