(1) The generalized form presents as erythematous or violaceous
papules on the trunk or extremities, which may combine to create multiple plaques with annular pattern.
Caption: FIGURE 1: (a) Erythematous-violaceous papules and an ulcerated violaceous
nodule on the patient's (left) and her daughter's (right) fingers; (b) a violaceous
erythematous lesion with red outer ring, and erythematous border on the right thumb of patient's daughter.
Left ventricular fold and ventricle exhibited a violaceous
The clinical examination of the skin revealed an extensive, well-demarked, erythematous, violaceous
, warm indurated lesion, covering the dorsal faces of both hands (Figure 1a).
(3,5) The prototypical appearance is a violaceous
, red rash, which may delay correct diagnosis when mistaken for bruising or post-radiation skin changes.
Cytomegalovirus is a DNA virus of the herpesvirus group which produces an enlargement of the infected cell, and microscopically with hematoxylin-eosin staining, a large 5-15 [beta]m sized violaceous
to dark red intranuclear inclusion surrounded by a thin clear halo can be seen.
FDE is characterized by the appearance of a single or multiple sharply demarcated violaceous
erythematous plaques which heal with residual hyperpigmentation.
Examination of the lower extremities revealed non-blanchable, well-defined palpable erythematous to violaceous
papules, and targetoid patches with a mild hemorrhagic necrotic center surrounded by a mild violaceous
to brownish borders.
The lesions are extremely painful and become increasingly violaceous
, with firm subcutaneous nodules.
Livedo reticularis is typically more violaceous
in appearance, with net-like, mottled discolouration of the skin due to deoxygenation and dilation of the venous plexus.
Several days later, a skin biopsy of the violaceous
, discoid-like lesion above the patient's eyebrows revealed atrophic dermatitis with marked telangiectasia, suggestive of lupus versus dermatomyositis.
Upper endoscopy revealed multiple large hypervascularized violaceous
submucosal nodular lesions with stigmata of recent bleeding on the soft palate and pharynx and within the cricopharyngeal area close to the vocal cords.