Walker, Clay W.

A 59-year-old woman presented with a persistent, nonpruritic erythematous rash on both lower extremities. Dermoscopy showed petechiae and hemosiderin deposition, and biopsy revealed perivascular lymphocytic infiltration with red blood cell extravasation, confirming Schamberg disease. Laboratory studies were unremarkable. Minimal improvement with topical corticosteroids prompted addition of oral rutoside, ascorbic acid, and pentoxifylline, resulting in gradual fading of lesions. Schamberg disease is a benign, chronic pigmented purpuric dermatosis that can mimic vasculitis. Diagnosis requires clinical and histologic correlation, and management focuses on cosmetic improvement and patient reassurance regarding its nonprogressive nature.

Rashes are a common issue in primary care, encompassing various differential diagnoses. Chilblain lupus erythematosus (CHLE), a subset of cutaneous lupus erythematosus (CLE), is a rare skin condition with limited documented cases. A young male patient presented with purple discoloration of his toes and fingers, along with violaceous skin scaling after exposure to cold temperatures. A positive antinuclear antibody test led to the diagnosis of CHLE and the initiation of treatment, resulting in a positive response.