Gehlhausen JR, Wetter DA, Nelson C, et al. - Researchers assessed inpatient consultations for complex purpura to record the most common diagnoses and verify the true diagnostic utility of histopathology, clinical morphology, and distribution. A case series of 68 inpatients were reviewed during a 4-year period with a dermatologic consultation for purpura and biopsy findings of vasculitis or microvascular occlusion. Most of the patients who died had acral branching lesions. Non-branching dependent purpura corresponded to leukocytoclastic vasculitis, with IgA vasculitis or skin-limited small-vessel vasculitis being the most common diagnoses. Patients with deep involvement also had systemic diseases. Branching purpura was caused in this series by microvascular occlusion rather than medium-vessel vasculitis and had associated high mortality.