In 1983, Milstone and coworkers studied seven patients who, in their view, presented themselves very similarly to each other with petechiae, purpuric papules, or hemorrhagic bullae, with small, depressed, interconnected scars that formed a reticular pattern, and with ulcers. Six of the patients also had what the authors designated livedo reticularis (see also livedo reticularis) (Figs. 8A–B). [30] The authors believed that the designation atrophie blanche" was misleading since it represented only the end stage of the process and they suggested using the acronym "PURPLE (painful purpuric ulcers with reticular patterning on the lower extremities)" instead. Thereby, they sought to convey that the diagnosis was based primarily on findings clinical and that multiple causes might be responsible for it. Milestone stated clearly, however, that the terms atrophie blanche, livedo reticularis with ulcerations, livedo vasculitis, and vasculitis of atrophie blanche were all referring to the same condition, which they suggested naming PURPLE.