Schamberg’s disease also known as purpura pigmentosa progressiva or progressive pigmented purpuric dermatitis is a chronic discoloration of the skin usually affecting the lower limbs. The discoloration is due to the deposition of haemosiderin as a result of blood leaking from tiny inflamed capillaries. The real cause of this disease is yet to be identified, but it is believed to be related to allergic reaction to some clothing dye, rubber, food preservatives, viral infection or secondary to drug reaction. Other condition that can influence the disease progression may be venous hypertension, exercise, and gravitational dependency.
Schamberg’s disease can occur at any age, any race and men are more affected then women. These disease may be confused with other purpuric disease. So your dermatologist may need to perform the skin biopsy and examine the sample under microscope.
The lesion most frequently occurs on lower limbs, but it can occur anywhere on the body. These lesion consist of irregular, itchy, purpuric patches of orange or fawn or brownish pigmentation with a characteristic ” cayenne pepper” spots usually localized on lower limbs. These purpura may last of up few weeks and occasionally longer. These patches may persist for many years.
There is no specific cure for Schamberg’s disease and as its not a life threatening, treatment is not always needed in many cases. Various treatment modalities have been tried which includes topical and systemic corticosteroids, vitamin C, laser therapy, topical and systemic anti-inflammatory agents. If there is any suspected precipitating factors or history of any allergic reaction to food, clothes or artificial coloring agents it should be avoided. It can also be due to current drug reaction, so any drugs taken during the time should be stopped with a doctor consultation.
For itching any topical or systemic antihistamines or mild topical corticosteroids may be applied. If there is infection antibiotics may be needed. For less severe cases wearing support stocking or surgery might help. For some severe cases Pentoxifylline have been tried with some success, but may not always work. Pentoxifylline improves the blood circulation and its safe to take ( less frequently one may experience stomach upset). Vitamin C 500mg twice daily, psoralen therapy, griseofulvin and few other options have been tried with mixed results.