Understanding Hemorrhage Classification

Hemorrhage Classification and Causes

• Purpura: Hemorrhage into the skin; further classified into palpable and non-palpable.

  • Palpable Purpura: Associated with vasculitis syndromes due to vessel wall inflammation.
  • Non-Palpable Purpura: Includes petechiae, small spots of hemorrhage measuring 3 mm.

• Hematoma: A larger hemorrhage causing skin elevation.

• Causes of Hemorrhage under the Skin:

  • Deficiency: Vitamin deficiencies, notably scurvy.
  • Infection: Conditions such as meningococcal meningitis, subacute bacterial endocarditis (SBE), and HIV.
  • Hematological Disorders: Includes thrombocytopenia, acute and chronic leukemias, platelet dysfunction, and aplastic anemia.

Skin Types and Their Indications

• Dry Skin: Indicators include myxedema and dehydration.
• Moist Skin: Often seen in shock, myocardial infarction, pneumonia crises, and thyrotoxicosis.
• Thick Skin: Associated with myxedema, acromegaly, and scleroderma.
• Thin Skin: Common in elderly individuals and those with wasting diseases.
• Pinched Skin: Suggestive of dehydration.

Hair Changes and Associated Conditions

• Falling Hair: Common post-infectious fevers, such as typhoid.
• Patchy Hair Loss: Seen in conditions like alopecia areata and syphilis.
• Loss of Outer Third of Eyebrows: Indicative of leprosy and myxedema.
• Absence of Axillary, Pubic, and Facial Hair: Associated with hypopituitarism and hypogonadism.
• Excessive Hair Growth in Women: Observed in Cushing's syndrome and adrenocortical syndrome.

Nail Examination and Findings

• Pallor: Suggestive of systemic issues.
• Koilonychia: Spoon-shaped nail deformity indicating iron deficiency anemia.
• Onychia: Nail deformities resulting from fungal or tuberculous infections.
• Discoloration: Can occur in conditions like Raynaud's disease and poisoning from silver or mercury.
• Clubbing and Cyanosis: Associated with various respiratory and cardiovascular conditions.