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Visual Treats in Dermatology

Schamberg’s disease affecting both upper and lower limbs

Department of Dermatology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India
Corresponding author: Surajbala Khuraijam, Department of Dermatology, All India Institute of Medical Sciences Rishikesh, Rishikesh, Uttarakhand, India.
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Khuraijam S, Devi MS. Schamberg’s disease affecting both upper and lower limbs. CosmoDerma 2022;2:42.

A 59-year-old male, presented with asymptomatic reddish-brown lesions over bilateral lower limbs for three years. Two months following the initial lesions, reddish-colored macules also developed over the bilateral forearms. A history of prolonged standing (eight to ten hours/day) was present.

On cutaneous examination, multiple discrete reddish-brown macules with ‘cayenne pepper spots’ were present over the bilateral ankles extending up to one-third of the lower legs [Figure 1a]. Bilateral forearms showed numerous discrete nonpalpable, nonblanchable petechiae [Figure 1b]. Dilated tortuous veins were visible in the legs.

Figure 1:: (a) Multiple discrete reddish – brown macules giving a ‘cayenne pepper appearance’ diffusely present over the bilateral ankles, predominantly around medial malleolus extending up to one-third of the legs. Numerous dilated tortuous veins visible over the bilateral shins. (b) Numerous pinhead size non palpable and non blanchable petechiae present over the extensors of bilateral forearms.

Biopsy taken from leg and forearm showed similar findings of increased vascularity in papillary dermis with edema, RBCs extravasation, perivascular, and periadnexal lymphocytic infiltrate. No leukocytoclasia or plump endothelial cells are seen ruling out leukocytoclastic vasculitis. Based on the clinical characteristics and histopathological findings, the patient was diagnosed with a case of Schamberg’s disease affecting both upper and lower limbs. Schamberg’s disease is a form of pigmented purpuric dermatoses which presents as asymptomatic reddish-brown macules resembling cayenne pepper appearance commonly presenting over the lower limbs.[1]

Declaration of patients consent

Patient consent is not required as the patient’s identity is not disclosed or compromised.

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There are no conflicts of interest.


  1. , , . Pigmented purpuric dermatoses: An overview. Int J Dermatol. 2004;43:482-8.
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