Post-puerperal Recurrent Depression

MEDICTLJOURNAL 637Contmeiet.-It is probable that this patient's non-thrombo- cytopenic purpura was an example of so-called anaphylac- toid purpura.It is noteworthy that she developed indurated areas of both legs before the onset of the purpura and that these subsequently ulcerated.The most reasonable conjecture would appear to be that both the indurated areas and the purpura were independent manifestations of the same underlying allergic state. DiscussionWe have no doubt that leg ulcers which persist for several months are decidedly rare in non-thrombocytopenic purpura.Davis (1948) reported-44,cases of Schonlein-Henoch purpura without mentioning ulceration among the skin lesions.Gendel (1948), in a review of the reported cases of chronic leg ulcer in diseases of the blood, likewise does not mention this association.Chronic leg ulcers have been observed in a number of blood dyscrasias, such as con- genital haemolytic anaemia, sickle-cell anaemia, poly- cythaemia, splenic anaemia, thrombocytopenic purpura, and Gaucher's disease, in all of which splenomegaly is a frequent finding, and it has been usual to attribute the liability to leg ulferation to some abnormal action of the spleen.We are grateful to Professor L.