Essential thrombocythemia is one of the myeloproliferative neoplasms. Palpable purpura is a rare manifestation that may delay diagnosis and treatment. We report a case of essential thrombocythemia in a 50-year-old man, who presented with recurrent thigh pain for the past one year with nonspecific localized purpura. His full blood count revealed isolated thrombocytosis of 880,000/µL with an impression of myeloproliferative disorder from peripheral blood film. He was referred urgently to the hematology team, which proceeded with a venesection. His condition improved with hydroxyurea. This was a rare case of chronic presentation of myeloproliferative neoplasm detected at a primary care clinic

In primary care, chest X-rays are commonly performed to assess patients presenting with a prolonged cough. However, the extent to which the flms are accurately interpreted depends on the skill of the doctors. Doctors with insufcient experience may miss an exact diagnosis when evaluating a flm, especially in patients with nonspecifc symptoms, such as in the case discussed in this paper. Tis case involved a persistent dry cough with an underlying diagnosis that would have been missed if the fndings of the chest X-ray had not been properly analyzed.