PurpuraDefinition: Purpura is purple-colored spots and patches that occur on the skin, organs, and in mucus membranes, including the lining of the mouth.
Alternative Names: Blood spots; Skin hemorrhages
Considerations: Purpura occurs when small blood vessels join together or leak blood under the skin.
When purpura spots are very small, they are called petechiae . Large purpura are called ecchymoses.
Platelets help the blood clot. A person with purpura may have normal platelet counts (nonthrombocytopenic purpuras) or low platelet counts (thrombocytopenic purpuras).
Common Causes: Nonthrombocytopenic purpuras may be due to:
- Amyloidosis
- Blood clotting disorders
-
Congenital cytomegalovirus
- Congenital rubella syndrome
- Drugs that affect platelet function
- Fragile blood vessels (senile purpura)
-
Hemangioma
- Inflammation of the blood vessels (vasculitis), such as Henoch-Schonlein purpura , which causes a raised type of purpura
- Pressure changes that occur during vaginal childbirth
-
Scurvy
- Steroid use
Thrombocytopenic purpura may be due to:
Call your health care provider if: Call your doctor for an appointment if you have signs of purpura.
What to expect at your health care provider's office: Your doctor will examine your skin and ask you questions about your medical history and symptoms, including:
- Is this the first time you have had such spots?
- When did they develop?
- What color are they?
- Do they look like bruises?
- What medications do you take?
- What other medical problems have you had?
- Does anyone in your family have similar spots?
- What other symptoms do you have?
A skin biopsy may be done.
References: Korman NJ. Macular, papular, vesicobullous, and pustular diseases. In: Goldman L, Ausiello D. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 465.
Coller BS, Schneidermann PI. Clinical evaluation of hemorrhagic disorders: the bleeding history and differential diagnosis of purpura. In: Hoffman R, Benz EJ, Shattil SS, et al. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2008: chap 121.
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