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Lower limb purpura in setting of acute paraplegia: cutaneous clue to a catastrophic cardiac event
  1. Anuradha bishnoi1,
  2. Ankur Guliani2,
  3. Keshavamurthy Vinay3,
  4. M Sendhil Kumaran2
  1. 1 Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2 Department of Dermatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  3. 3 Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Keshavamurthy Vinay, Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India; vinay.keshavmurthy{at}gmail.com

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A middle-aged shopkeeper, with type II diabetes mellitus presented with purple-black skin discolouration on both lower limbs, extending from toes till upper thighs (figure 1A,B, C). He complained of sudden bilateral lower extremity weakness 9 days back, after 2 days of which, he started having dusky discolouration on his toes that had progressed proximally. Sphincter function was preserved and there was no history of smoking, preceding claudication, trauma, new drug intake or intramuscular injections. The limbs were cold, and motor activity and sensations were impaired below the knee. Bilateral popliteal and tibial arteries were non-palpable.

Figure 1a

Characteristic geographical cutaneous purpura with geometrical angulated margins on …

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Footnotes

  • Contributors AB and KV had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: AB and AG. Acquisition, analysis and interpretation of data: AB, AG, MSK and KV. Drafting of the manuscript: AB and AG. Critical revision of the manuscript for important intellectual content: MSK and KV. Statistical analysis: None. Administrative, technical, or material support: No. Study supervision: KV.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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