A painful hemorrhagic blister on the leg

History and clinical findings: A 87-year-old lady was admitted to the medical ward with urinary tract infection. It was noted to have sudden painful bleeding blisters in her lower legs of 1 week duration. She had a background of stage 4 chronic renal failure since 2009 and was diagnosed of urothelial bladder cancer in December 2015. She was on Bisoprolol, calcichew, folic acid, isosorbide mononitrate, zomorph, ranitidine, levothyroxine, buscopan and paracetamol. On examination there was a large 1 cm × 2 cm hemorrhagic blister on her left lower leg on background of multiple tender purpuric and necrotic plaques on both lower legs.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research