Pinch purpura around eyelids is one of the most common finding in:-

Answer is B (Primary Systemic Amyloidosis): Pinch Purpura is typical of Primary Systemic Amyloidosis. Skin blood vessels infiltrated with amyloid rupture easily, causing 'pinch purpura' to occur after minor trauma. Purpura of the eyelids following pinching or minor trauma (pinch purpura); periorbital purpura (Racoon Eyes) precipitated by coughing, vomiting or the valsalva munoeuver, and purpura around the eyelids after Proctoscopy (PostProctoscopic Palpebral Purpura) are very characteristic findings in Primary Systemic Amyloidosis Typical Purpura in Primary Systemic Amyloidosis Pinch Purpura Racoon Eyes Post-Proctoscopy Palpebral Purpura (PPPP) Features Purina-a of the eyelids - pinching or minor trauma Periorbital purpura precipitated by coughing, vomiting or the l'alsalva manoeuver Purpura around eyelids in patients who have been positioned head down fir investigation Proetoscopv