Clinical Patterns and Risk Factors Associated With Pigmented Purpuric Dermatoses

Objectives: Authors aimed to investigate clinical patterns, characteristics and risk factors associated with pigmented purpuric dermatoses (PPD) in Pakistani population and to correlate the relationship of various suggested aetiologic agents with PPD in our population. Methods: Retrospective analysis of 65 patients was done who visited The Indus Hospital, Karachi between October 2017 to March 2020. Demographics, comorbids, body mass index (BMI), PPD type, clinical findings, laboratory parameters and ultrasonographic findings (USF) of both lower limbs for venous insufficiency were reviewed.  Results: Mean age of patients was 42.6±13.9 years with male to female ratio of 1.2:1. Majority were housewives (40.3%). Schamberg’s disease was present in 64.6%. Obesity was present in 78.1%. Reflux in superficial venous system in 52.3% on ultrasonography, detectable dilated veins in 58.5% and presence of venous stasis in 30.8% PPD cases were found. Males were twice more commonly affected with varicosities. Hypertension (46.2%), diabetes (27.8%) and hyperlipidemia (18.5%) were most common comorbids. Statistically significant differences were detected between USF (p=0.01) and clinical varicosities (p=0.04) when Schamberg’s disease and other PPD were compared; while no association was found with respect to age, gender, occupation, BMI and type of comorbids in these two groups. Conclusion: Venous insufficiency, obesity, and comorbidities like hypertension, diabetes and hyperlipidemia were main cofactors linked with PPD in our population.