Granulomatous pigmented purpuric dermatosis.

Granulomatous pigmented purpuric dermatosis (GPPD) is a rare histologic variant of pigmented purpuric dermatosis (PPD). It includes classic histology changes of PPD with superimposed granulomas. This variant is thought to be associated with hyperlipidemia and is found predominantly in individuals in the Far East; however, a review of the literature that included 26 documented cases of GPPD revealed these associations might be becoming less clear. We report a case of GPPD in an elderly white man who had an eruption involving the majority of the lower legs.