Schamberg's disease

Schamberg's disease (Progressive pigmented purpuric dermatoses) 

• Capillarits of unknown etiology seen in  young adults
• Commonest site is legs
• Asymptomatic
• The commonest type of capillaritis seen
• Gravity and increased venous pressure are important in etiology
• A true vasculitis is not seen on skin biopsy. Blood cells pass through small gaps that arise between the endothelial cells, which make up the capillary walls. The result is tiny red dots appear on the skin, described as cayenne pepper spots. They group together to form a flat red patch, which becomes brown due to hemosiderin deposition in the skin. 
• The disease follows a chronic course with spontaneous clearance in a few cases. 
• Treatment modalities which have been used include topical and systemic corticosteroids, vitamin C and topical and systemic anti inflammatory agents. Pentoxifylline, a methylxanthine derivatice, has been used successfully in treatment. Leg elevation and compression stockings also help