Petechiae and Purpura Diagnosis

Purpura

• Petechiae can be seen on the thighs
• Can be caused by anemia and low ascorbic acid level, treated with ascorbic acid administration

Types of Purpura

• Purpura of Unknown Origin
• Purpura Simplex (Simple Purpura or Devil's Pinches)
  • Caused by skin fragility
  • Seen in older individuals or those undergoing corticosteroid therapy
  • Bleeding is superficial
• Senile Purpura
  • Seen in older individuals or those undergoing corticosteroid therapy
  • Purpuric lesions/bruises occur on the hands and arms
• Drug-Induced Purpura
  • Caused by iodides, quinine, procaine, penicillin, and aspirin
• Psychogenic Purpura
  • Seen in individuals with emotional problems, often after severe trauma or extensive surgery
  • Hypersensitive to RBC membrane components or DNA hypersensitivity
• Scurvy
  • Caused by a deficiency in Vitamin C (ascorbic acid)
  • Decreased synthesis of collagen with weakening of capillary walls
  • Commonly seen in children; renal dysfunction is common and typically reversible in children

Acquired Vascular Disorders

• Caused by external/environmental problems
• Examples include:
  • Infections (e.g., Rickettsia, viruses, cocci)
  • Septic emboli to the skin (Ecthyma gangrenosum) in endocarditis

Allergic Purpuras

• Anaphylactic Purpura
  • Characterized by a relatively distinctive purpuric eruption with constitutional and localized symptoms
• Nonthrombocytopenic Purpura
  • Characterized by allergic manifestations - skin rash and edema
  • Associated with certain foods, drugs, cold, and insect bites
  • Caused by autoimmune process or allergic vasculitis

Purpura Fulminans

• Characterized by sudden onset, fever, prostration, symmetric circumscribed ecchymoses, and infarcts of the skin and frequently gangrene of the extremities
• Caused by diffuse vascular injury and intravascular coagulation
• Can be seen in any purpura with rapid onset

Hyperviscosity Syndrome

• Results from hypergammaglobulinemia
• Caused by an increase in plasma viscosity