Purpura fulminans is an acute, rapidly progressive hemorrhagic necrosis of the skin attributable to dermal vascular necrosis that is associated with disseminated intravascular coagulation. It is a rare and occasionally life-threatening disorder that occurs most commonly in the setting of acute, severe bacterial or viral infection, or as a postinfectious syndrome after infections such as primary varicella or scarlet fever.1–4 Postinfectious purpura fulminans usually occurs 7 to 10 days after onset of symptoms of the acute infection. The ecchymotic lesions are most commonly distributed symmetrically on the lower extremities and buttocks, although the trunk and upper extremities can be involved. Visceral involvement is less frequent but can lead to hematuria or gastrointestinal hemorrhage.

Transient or congenital deficiencies of protein C or protein S have been documented in many cases of purpura fulminans in recent years.,4 ,7 ,8  Protein C is the best known among the...

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