Factitious Purpura

This 3-year-old girl was brought to the physician’s office for evaluation of a nonpruritic, purple discoloration around her mouth. The patient’s mother reported that the rash developed after the child had eaten a mango and sucked on a cup. The eruption in the circumoral area was diagnosed as a factitious purpura. The discoloration was caused by sucking on a cup, which created a negative pressure around the mouth that resulted in the circumoral purpura. The mango played no part in the patient’s condition. No treatment was given for the purpura, which resolved on its own. (Case and photograph courtesy of Drs Alexander K. C. Leung and C. Pion Kao.)