PLANTAR PURPURA DUE TO CARDIAC MYXOMA

After experiencing painful purpura on the volar aspect of the left hand that resolved after a few days, a 52-year-old man had a relapse consisting of purpura on the left plantar area followed by the onset of left hemiplegia and dysarthria. A biopsy of the purpura of the left plantar lesion was conducted revealing subcutaneous intracapillary occlusion positively stained with Alcian blue and calretinin. 

 

Clinical image of soles, hematoxylin-eosin stain

 

Computed tomography and echocardiography detected a right cerebral infarction and a 23 mm mass in the left atrium which was resected, leading to a diagnosis of cardiac myxoma and the conclusion that the painful plantar purpura was due to cardiac myxoma. (Yoshihito, O, et al. Painful Palmar and Plantar Purpura, JAMA Dermatol. Online June 30, 2021) 

 

Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL

Courtesy of Barry Block, editor of PM News