Rumpel-Leede phenomenon in a hypertensive patient due to mechanical trauma: a case report

J Med Case Rep. 2016 Jun 5;10(1):150. doi: 10.1186/s13256-016-0950-3.

Abstract

Background: In this report, we present an interesting case of a patient with Rumpel-Leede phenomenon, a rare occurrence that can result in significant delays in medical treatment. This phenomenon is characterized by the presence of a petechial rash that results from acute dermal capillary rupture. In our patient, it occurred secondary to raised pressure in the dermal vessels caused by repeated inflation of a sphygmomanometer cuff. Contributory factors in Rumpel-Leede phenomenon include prevalent conditions such as diabetes mellitus, hypertension, thrombocytopenia, chronic steroid use, antiplatelets, and anticoagulants.

Case presentation: A 58-year-old Russian woman with diabetes and hypertension presented to our hospital with a non-ST elevation myocardial infarction, and she subsequently developed a petechial rash on her distal upper limbs. A vasculitic screen was performed, with normal results.

Conclusions: Given the timing and distribution of the rash, it was felt that this was an example of Rumpel-Leede phenomenon in a susceptible individual. This is an important diagnosis to be aware of in patients with vascular risk factors presenting for acute medical care who subsequently develop a petechial rash.

Keywords: Diabetes mellitus; Mechanical trauma; Petechial rash; Rumpel-Leede phenomenon.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / adverse effects*
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / drug therapy
  • Blood Pressure Determination / adverse effects*
  • Diabetes Mellitus, Type 2 / complications*
  • Female
  • Humans
  • Hypertension / complications*
  • Middle Aged
  • Myocardial Infarction / complications*
  • Purpura / etiology*
  • Risk Factors
  • Warfarin / adverse effects*

Substances

  • Anticoagulants
  • Warfarin