Mucosal lesions of a thrombocytopenia patient

Mucosal lesions of a thrombocytopenia patient (from NEJM image challenge)

A 76-year-old man presented to the dermatology clinic with a 2-day history of blood-filled blisters on the tongue. He reported no prior trauma or other bleeding symptoms. Physical examination was notable for hemorrhagic bullae on the tongue and gingiva, and purpura on the arms and legs.