Annular purpuric rash on the lower extremities

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Annular purpuric rash on the lower extremities
Annular purpuric rash on the lower extremities

A 47-year-old man had a three-month history of intermittent rash on the lower legs. The rash consisted of symmetric ringlike coalescing purpuric patches in a netlike pattern. There were no ulcerations, vesicles, or bullae. The asymptomatic rash was not palpable or associated with fevers, arthralgia or arthritis, oral ulcers, or hair loss. Other health issues were mild hypertension controlled on enalapril and hepatitis C likely acquired with the three amateur tattoos he got while in prison 20 years ago. 

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