Skin lesions in paroxysmal nocturnal hemoglobinuria

Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon hemolytic anemia that rarely manifests skin lesions. Leg ulcers and purpura similar to the manifestation of thrombotic thrombocytopenic purpura (TTP); disseminated intravascular coagulation, and Henoch-Schönlein purpura do occur. This is the second known case report of PNH with histopathologic features of TTP. Clinically, our patient's condition resembled TTP with disseminated intravascular platelet aggregation, and she followed a nonfulminant course. She improved on a regimen of systemic steroids, dipyridamole, and cessation of antibiotics.