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A Journal on Dermatology

Journal of Istituto Dermatologico San Gallicano
Official Journal of the Associazione Dermatologi Ospedalieri Italiani - A.D.O.I.
Indexed/Abstracted in: EMBASE, Scopus



Esperienze Dermatologiche 2010 March;12(1):17-21

language: English, Italian

Acute promyelocitic leukemia presenting with retiform purpura

Brunasso A. M. G. 1,2, Pozzessere D. 3, Destefanis M. 3, Santini S. 3,4, Curcic P. 2, Massone C. 2

1 Dipartimento di Dermatologia, Ospedale Galliera, Genova, Italia
2 Dipartmento di Dermatologia, Università di Medicina di Graz, Graz, Austria
3 Unità di Oncologia Medica Sandro Pitigliani, Dipartimento di Oncologia, Ospedale di Prato, Prato, Italia
4 Dipartimento di Ematologia, Ospedale di Prato, Prato, Italia


Retiform purpura (RP) is an uncommon type of purpura that indicates an acute thrombotic occlusion. RP can be associated to different vascular inflammatory or not inflammatory conditions. Early recognition is essential as RP is characterized by high mortality and morbidity. A 57-year-old presented with purpura and a bluish painful discoloration on the right foot where vessels of the cutaneous plexus were visible. Evaluations revealed pancytopenia and thrombi along the common and superficial femoral right arteries. Despite heparin, nifedipine, hyperbacic oxygen and surgical thrombectomy, only a partial improvement was obtained until amputation was required. Only the second bone marrow biopsy displayed for an acute promyelocytic leukemia. The patient died during an urgent laparotomy that disclosed thrombosis in the proximal branches of the superior mesenteric artery. Thrombosis is an unusual presenting sign of leukemia and skin presentation of acute promyelocytic leukemia with RP has not been reported yet.

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