Clotting and thrombotic disorders of the skin in children

The skin is often the presenting organ for thrombotic disorders. Purpura fulminans, with its widespread cutaneous necrosis, may be the result of severe infection, of an inherited or acquired disorder of the protein C procoagulant pathway, or of unknown causes (the idiopathic form). Recurrent venous or arterial thrombosis and the associated skin findings at an early age may be clues to an inherited disorder of protein C, protein S, or antithrombin III. Livedo reticularis, leg ulcerations, and hemorrhagic purpura may suggest the antiphospholipid antibody syndrome.