Emre Burakhan AKAY, Nihal SARI, Sevgi KULAKLI, Birgül TOK
Turkish Journal of Dermatology - 2026;20(2):84-87
Pigmented purpuric dermatoses (PPD) are chronic capillaritides characterized by petechiae, purpura, and brown macules. We present a biopsy-confirmed case of Schamberg disease with rapid clinical improvement following a 2-week course of oral pentoxifylline. A 25-year-old woman presented with an approximately 5-year history of recurrent asymptomatic petechial eruptions affecting the upper and lower extremities. Dermoscopy demonstrated reddish, round-to-oval globules and dots on a brownish background. Ultraviolet-induced fluorescence (UV-F) dermoscopy enhanced the visibility of active petechial foci and assisted in selecting an optimal biopsy site. Histopathology revealed a superficial perivascular lymphocytic infiltrate with focal erythrocyte extravasation and pigment-laden macrophages in the papillary dermis; features of leukocytoclastic vasculitis were absent. After failure of topical high-potency corticosteroids and topical calcineurin inhibitors, controlled-release pentoxifylline 600 mg once daily was initiated. Near-complete clinical resolution was observed by day 14. Treatment was discontinued because of nausea and vomiting, and remission persisted at 2-month follow-up. This case suggests that pentoxifylline may be associated with early clinical improvement in selected patients with PPD and highlights UV-F dermoscopy as a practical adjunct for identifying active purpuric foci and selecting a biopsy site.
