Akademik Veri Yönetim Sistemi
21st Congress of the European Society of Dermatology and Psychiatry & 1st World Congress of Psychodermatology, İstanbul, Türkiye, 28 - 31 Mayıs 2025, cilt.19, ss.132, (Özet Bildiri)
Aim: Gardner-Diamond Syndrome (GDS), also known as psychogenic purpura, is a rare psychodermatological condition primarily characterized by recurrent painful ecchymoses (bruises) and normal coagulation profiles. Emotional stress and underlying psychiatric factors -such as anxiety, depression, or somatization- play a critical role in the manifestation of these bruises. In most cases, all laboratory findings remain within normal ranges, and the diagnosis is established after excluding other potential bleeding diatheses in conjunction with a psychiatric evaluation. Case Report: A 52-year-old married female patient with two children presented with a two-year history of recurrent painful bruises, primarily on the lower extremities, occasional mild joint pain, and high levels of anxiety. The lesions typically appeared after minor trauma, regressed within a few days, and coincided with periods of intense emotional stress. Her medical history included seronegative undifferentiated arthritis and fibromyalgia-like symptoms, for which she had been treated with sulfasalazine, corticosteroids, and immunosuppressive agents at various times. However, hematological and dermatological evaluations (including complete blood count, coagulation tests, and skin biopsies) were all normal. GDS was therefore considered; after ruling out coagulopathies and factitious disorders, the diagnosis was confirmed. Psychiatric assessment revealed high levels of anxiety related to sleep disturbances and familial conflicts, along with a marked tendency toward somatization. During treatment, duloxetine 60 mg/day along with an additional 50 mg/day of trazodone led to improvements in anxiety and sleep disturbances, and the painful ecchymoses partially subsided as well. Conclusion: GDS should be considered in patients presenting with recurrent painful bruises of unknown organic origin, particularly when emotional stress and psychiatric symptoms are prominent. Early diagnosis and a multidisciplinary approach are crucial in preventing unnecessary investigations and inappropriate treatments, and in improving patients’ quality of life. Identifying psychosocial factors and employing a combination of appropriate pharmacotherapy and psychotherapy are key components in the management of this syndrome.