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'''For patient information click [[Purpura (patient information)|here]]'''
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = {{PAGENAME}} |
   Name          = {{PAGENAME}} |
   Image          = Purpura.jpg |
   Image          = Purpura.jpg |
   Caption        = |
   Caption        = |
  DiseasesDB    = 25619 |
  ICD10          = {{ICD10|D|69||d|65}} |
  ICD9          = {{ICD9|287}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
  MeshID        = D011693 |
}}
}}
{{SI}}
{{Purpura}}
{{CMG}}
{{CMG}}


{{Editor help}}
{{SK}} Skin hemorrhages


'''Purpura''' (from the Latin, ''purpura'', meaning "purple") is the appearance of red or purple discolorations on the [[skin]], caused by [[bleeding]] underneath the [[skin]]. Small spots are called [[petechia|petechiae]], while large spots are called [[ecchymoses]].
==[[Purpura overview|Overview]]==


This is common with [[typhus]] and can be present with [[meningitis]] caused by [[meningococcal]] meningitis or [[septicaemia]].
==[[Purpura historical perspective|Historical Perspective]]==


==Classification==
==[[Purpura classification|Classification]]==
Purpura is a common and unspecific symptom, however the underlying mechanism commonly involves one of the following:


*[[Platelet|Platelet disorders]]
==[[Purpura pathophysiology|Pathophysiology]]==
**[[idiopathic thrombocytopenic purpura|Primary thrombocytopenic purpura]]
**Secondary thrombocytopenic purpura
*Vascular disorders
**Microvascular injury, as seen in senile (old age) purpura, when blood vessels are more easily damaged
**Hypertensive states
**Deficient vascular support
**[[Vasculitis]], as in the case of [[Henoch-Schönlein purpura]]
*[[Coagulopathy|Coagulation disorders]]
**[[Disseminated intravascular coagulation]] (DIC)


There are also cases of psychogenic purpura described in the medical literature,<ref name="pmid10069314">{{cite journal |author=Anderson JE, DeGoff W, McNamara M |title=Autoerythrocyte sensitization (psychogenic purpura): a case report and review of the literature |journal=Pediatric emergency care |volume=15 |issue=1 |pages=47-8 |year=1999 |pmid=10069314 |doi=}}</ref> some claimed to be due to "autoerythrocyte sensitization". Other studies<ref name="pmid8340191">{{cite journal |author=Lotti T, Benci M, Sarti MG, Teofoli P, Senesi C, Bonan P, et al. |title=Psychogenic purpura with abnormallt cutaney increased tPA dependeny |journous fibrinolytic activital=Int J Dermatol |volume=32| issue=7 |pages=521-3 |year=1993 |pmid=8340191 |doi=}}</ref> suggest, that local (cutaneous) activity of [[tPA]] can be increased in psychogenic purpura, leading to substantial amounts of localized plasmin activity, rapid degradation of fibrin clots, and resultant bleeding.
==[[Purpura causes|Causes]]==


== Differential Diagnosis of Causes of {{PAGENAME}} in alphabetical order==  
==[[Purpura differential diagnosis|Differentiating Purpura from other Diseases]]==


In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
==[[Purpura epidemiology and demographics|Epidemiology and Demographics]]==


*[[Allopurinol]]
==[[Purpura risk factors|Risk Factors]]==
*[[Atropine]]
 
*"[[Blueberry muffin baby]]"
==[[Purpura natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
*Child abuse
*[[Chloral hydrate]]
*Chronic stasis
*[[Churg - Strauss syndrome]]
*[[Cimetidine]]
*[[Corticosteroids]]
*[[Coxsackie Virus]]
*[[Disseminated Intravascular Coagulation]]
*[[Echo Virus]]
*[[Ehlers-Danlos syndrome]]
*Factitious purpura
*[[Factor VIII deficiency]]
*Factor IX deficiency
*[[Gardner-Diamond Syndrome]]
*[[Gold]]
*[[Hemolytic Uremic Syndrome]]
*[[Henoch - Schonlein Purpura]]
*[[Hepatitis B]]
*[[Hereditary hemorrhagic telangiectasia]]
*[[Hodgkin's Lymphoma]]
*[[Hydralazine]]
*[[Iodine]]
*[[Ketoconazole]]
*[[Leukocytoclastic vasculitis]]
*[[Liver Disease]]
*[[Lupus Erythematosus]]
*[[Measles]]
*[[Meningococcemia]]
*[[Myeloma]]
*[[Penicillin]]
*[[Phenytoin]]
*[[Platelet]] dysfunction
*[[Polyarteritis Nodosa]]
*[[Propylthiouracil]]
*[[Quinidine]]
*Religious rituals
*[[Rheumatoid Arthritis]]
*[[Rocky Mountain Spotted Fever]]
*[[Scurvy]]
*[[Scarlet Fever]]
*[[Sjogren's Syndrome]]
*[[Septic emboli]]
*[[Serum sickness]]
*[[Strangulation]]
*[[Subacute bacterial endocarditis]]
*[[Sulfonamides]]
*[[Tetracycline]]
*[[Thiazides]]
*[[Thrombocytopenia]]
*[[Typhoid]]
*[[Vitamin K deficiency]]
*Violent coughing
*[[Vomiting]]
*[[Von Willebrand's Disease]]
*[[Wegener's Granulomatosis]]


==Diagnosis==
==Diagnosis==
[[Purpura history and symptoms|History and Symptoms]] | [[Purpura physical examination|Physical Examination]] | [[Purpura laboratory findings|Laboratory Findings]] | [[Purpura other diagnostic studies|Other Diagnostic Studies]]


=== History and Symptoms ===
==Treatment==
*present illness
*medicinal history
*system review
*CNS symptoms


===Physical examination===
[[Purpura medical therapy|Medical Therapy]] | [[Purpura primary prevention|Primary Prevention]] | [[Purpura secondary prevention|Secondary Prevention]] | [[Purpura cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Purpura future or investigational therapies|Future or Investigational Therapies]]
<gallery>
Image:Purpura1.jpg|Petechial spots over the back
</gallery>


=== Laboratory Findings ===
==Case Studies==
*Labs include
[[Purpura case study one|Case #1]]
:*[[ANA ]]
:*Blood cultures
:*[[BUN]] / [[Creatinine]]
:*[[CBC]] with differential
:*[[C-reactive protein]]
:*[[ESR]]
:*PT/[[PTT]]/[[INR]]
:*[[urinalysis]]
:*[[LFT]]s
:*[[Rheumatoid factor]]


== Treatment==
{{Hematology}}
 
=== Acute Pharmacotherapies ===
*Infections
:*RMSF - doxycycline
:*Meningococcemia - ceftriaxone
 
=== Chronic Pharmacotherapies ===
*Autoimmune disease
:*[[methotrexate]]
:*[[cyclosporine]]
:*[[azathioprine]]
:*mycopheolate mofetil
 
== Primary Prevention ==
*Discontinue contributory medication
*Sun protection
*Avoid trauma


==References==
<references/>
==Further reading==
* [http://www.aafp.org/afp/20010801/419.html Evaluating the Child with Purpura] from [[American Academy of Family Physicians]]
{{Hematology}}
{{SIB}}
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[[Category:Dermatology]]
[[Category:Dermatology]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Medical signs]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Physical examination]]
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[[Category:Emergency medicine]]
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Latest revision as of 23:54, 29 July 2020

For patient information click here

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Skin hemorrhages

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Purpura from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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