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

• Published in: Journal of medical case reports Vol. 10; no. 1; p. 150
• Main Authors: Hartley, Adam, Lim, Phang B., Hayat, Sajad A.
• Format: Journal Article
• Language: English
• Published: London BioMed Central 05.06.2016; BioMed Central Ltd
• Subjects: Anticoagulants - adverse effects; Atrial Fibrillation - complications; Atrial Fibrillation - drug therapy; Blood Pressure Determination - adverse effects; Care and treatment; Case Report; Case studies; Diabetes Mellitus, Type 2 - complications; Diagnosis; Disease; Family Medicine; Female; General Practice; Humans; Hypertension - complications; Internal Medicine; Medical treatment; Medicine; Medicine & Public Health; Middle Aged; Myocardial Infarction - complications; Primary Care Medicine; Public Health; Purpura (Pathology); Purpura - etiology; Risk Factors; Surgical Oncology; Warfarin - adverse effects; Petechial rash; Rumpel-Leede phenomenon; Diabetes mellitus; Mechanical trauma
• ISSN: 1752-1947; 1752-1947
• DOI: 10.1186/s13256-016-0950-3

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.