HEMOSTASIS AND PLATELET AGGREGATION IN I'URPURIC PIGMENTED ANGIODERMATITIS ERUPTIONS

Ten patients with chronic purpuric and pigmented angiodermatitis in the extremities and two patients with acute and disseminated eczematoid-like purpura angiodermatitis were studied with current hemostasis parameters: (1) platelet aggregation, (2) platelet circulating aggregates, (3) clotting factor measurements and high molecular weight kininogen (HMWK) in their coagulation fraction. The results showed: (1) reactional thrombocytosis with morphologic changes; (2) increased levels of platelet circulating aggregates; (3) increased response of platelet aggregation to different agonists, especially at very low doses, and also when we used washed platelets resuspended in normal plasma; (4) delayed activation of the contact system; (5) decrease of the activity of the fibrinolysis activators; and (6) diminished function activity of the HMWK coagulation fraction. As a physiopathogenic hypothesis in these patients, there is a cutaneous pathology that could be entailed to these hematologic alterations of the platelet-HMWK-endothelial cells-kinins-coagulation-fibrinolysis system.