Purpura jaune d'ocre L81.9

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 04.04.2023

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Synonym(s)

Congestive bleeding; dermite ocre favre-chaix; Favre Chaix Syndrome; ochre dermatitis; Ochre purple; purpura orthostatica; Stasis bleeding; Stasis purpura (Favre-Chaix)

History
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Favre et al., 1924; Chaix, 1926

Definition
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Congestive bleeding in chronic venous insufficiency. It can be assumed that this clinical picture is identical with the angiodermite purpurique et pigmentée. S.a. Venous diseases.

Etiopathogenesis
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Increased hydrostatic pressure (chronic venous insufficiency). Chronic form: anaemia, increase of megakaryocytes in the bone marrow, rarely reduction due to exhaustion. Shortened platelet survival time.

Manifestation
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Occurs in older adults, mostly in people with chronic venous insufficiency (CVI).

Localization
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Especially extensor sides of the toes, back of the foot and lower legs

Clinical features
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Initially recurrent punctiform, later permanent, merging into larger spots and patches, partly red, partly reddish-brown or ochre, non-symptomatic (no itching, no scaling), skin discoloration. There is a relapse dependency of orthostatic straining functions associated with swelling of the lower legs (e.g. due to prolonged standing).

Differential diagnosis
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Purpura pigmentosa progressiva

Hereditary thrombocytopenia

Drug-induced or infectious thrombocytopenia

Papillomatosis cutis lymphostatica in lymphedema

Therapy
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Treatment of the underlying disease. Accompanying compression therapy, see below venous insufficiency, chronic.

Progression/forecast
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Acute form: Healing, relapses or transition to a chronic form (10%) are possible. Chronic form: Recurrent relapses.

Literature
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  1. Chaix A (1926) La dermite pigmentée et purpurique des membres inférieurs. Lésions pré-erosives des ulcères dits variqueux. Lyon
  2. Favre M, Contamin N, Martine R (1924) La dermite pigmentée et purpurique et les phlébites chroniques syphilitiques des membres inférieurs. Syphilis et ulcères dits variqueux. Lyon méd 5: 122
  3. Mekkes JR et al (2003) Causes, investigation and treatment of leg ulceration. Br J Dermatol 148: 388-401
  4. Odeh F, Goos M (1972) On the histopathology of the Dermite Ocre Favre chaix. Z Skin u Geschl Kr 47: 147-154
  5. Sawada et al (1991) Orthostatic purpura: report of two cases. Rinsho Ketsueki 32:1569-1573

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Last updated on: 04.04.2023