Pigmented purpuric dermatosis is a chronic condition characterized by reddish-brown skin lesions caused by leaky capillaries. Although they can arise on any part of the body, they are most commonly located on the lower legs. In some cases, the skin lesions cause severe itching. The skin lesions may spread over time, or clear up on their own. The cause of pigmented purpuric dermatosis is unknown. While treatment may not be necessary, topical steroids may help control itching. Other options for management include compression stockings, oral medications, and phototherapy.

The main features of pigmented purpuric dermatosis (PPD) are petechiae (tiny red spots due to broken blood vessels) or purpura (purple-colored spots or patches due to broken blood vessels), and yellow to brown pigmented patches. The most common sites are the legs, although lesions also may develop in other areas. Infrequently, PPD manifests as a generalized rash. The palms of the hands, soles of the feet, genitalia, and mucosa typically are not affected. Depending on the type of PPD a person has, additional signs and symptoms may include red-brown patches, plaques, linear lesions, itching, and/or other features. In general, PPD does not cause serious health problems but is a chronic condition. Signs and symptoms may persist, wax and wane, or slowly progress, and may go away over a period of months to years.

If the condition is mild, treatment may not be necessary. For those who suffer from itching, topical steroids and antihistamines may be useful. Compression stockings may be used if the lower legs are affected. Additional treatments that have been successful in limited studies include pentoxifylline, aminaphtone, photochemotherapy (PUVA), griseofulvin, oral cyclosporin, and ascorbic acid with rutoside.