Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

Information for Patients

View all Images (116)

Capillaritis in Adult
Other Resources UpToDate PubMed

Capillaritis in Adult

Contributors: David O'Connell MD, Connie R. Shi MD, Belinda Tan MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Capillaritis (also known as benign pigmented purpura and pigmented purpuric dermatosis [PPD]) is a dermatologic condition resulting from inflammation and disruption of papillary dermal vessels, with subsequent extravasation of red blood cells. The subtypes of capillaritis differ in both demographics and clinical presentation, with overlap noted. Lesions are characterized by cayenne-pepper-like petechiae, purpura, and golden-brown pigmentation. While classically macular, with more intense inflammation, papular lichenoid or eczematous changes may also be exhibited.

Capillaritis in its most common form is typically asymptomatic, but in some types, it may be pruritic, mildly painful, or may burn. It is usually chronic with intermittent exacerbations and remissions. There is no geographic or hereditary predilection. Atypical presentations of capillaritis not consistent with the following classification should raise the suspicion of some other underlying condition.

The well-described PPDs are:

Classic forms
  • Schamberg disease – the most common manifestation of PPD; affects middle-aged to older men
  • Purpura annularis telangiectodes (Majocchi disease) – uncommon; affects adolescents to young adults; most common in females
  • Eczematid-like purpura of Doucas and Kapetanakis – a more inflammatory and less common subtype of Schamberg disease
  • Pigmented purpuric lichenoid dermatosis of Gougerot and Blum – rare; most common in middle-aged men
  • Lichen aureus – most common in young men
Other forms
  • Linear pigmented purpura – uncommon; most commonly affects children and adolescents
  • Granulomatous pigmented purpura – very rare; most common in middle-aged to older adults and Asian individuals
  • Golfer's vasculitis (exercise-induced vasculitis; hiker's rash) – relatively common but underrecognized. Lower leg PPD associated with prolonged walking or hiking in hot and humid conditions. Seen mostly in people aged 50 years and older. It typically spares the compression band area of socks and resolves over a few days without treatment.
Development or worsening of preexisting capillaritis has been associated with venous hypertension, increased capillary fragility, gravity, exercise, and focal infections. Alcohol use disorder, especially with associated liver damage, appears to be an additional risk factor for Schamberg disease. There has been at least one case of Majocchi pigmented purpura following sclerotherapy treatment of the legs. Capillaritis has also been reported as a rare sequela of SARS-CoV-2 vaccination, both primary and booster.

Codes

ICD10CM:
I78.8 – Other diseases of capillaries

SNOMEDCT:
85461008 – Capillaritis

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

Subscription Required

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Subscription Required

References

Subscription Required

Last Reviewed:03/03/2024
Last Updated:04/10/2024
Copyright © 2024 VisualDx®. All rights reserved.
Patient Information for Capillaritis in Adult
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
Capillaritis in Adult
A medical illustration showing key findings of Capillaritis (Schamberg Disease)
Clinical image of Capillaritis - imageId=221951. Click to open in gallery.  caption: 'Multiple tiny, cayenne pepper-type petechiae and golden-brown macules on the thigh.'
Multiple tiny, cayenne pepper-type petechiae and golden-brown macules on the thigh.
Copyright © 2024 VisualDx®. All rights reserved.