Hypergammaglobulinemic Purpura of Waldenström With Primary and Autoimmune Associations.

Hypergammaglobulinemic purpura of Waldenström (HGPW) is a rare chronic purpuric eruption, usually on the lower legs, associated with polyclonal hypergammaglobulinemia, elevated erythrocyte sedimentation rate, and IgG and IgA rheumatoid factor, and can be primary or secondary to autoimmune disease. In this article, we present 2 cases of HGPW. Thorough evaluation and rheumatology follow-up are recommended, with treatment from conservative measures to systemic agents for frequent or painful flares.