purpura

What is Purpura?

Purpura is a medical condition characterized by the appearance of purple-colored spots and patches on the skin, as well as in mucous membranes such as the lining of the mouth [1]. This discoloration occurs due to hemorrhage from small blood vessels, causing blood to leak into the surrounding tissue [2].

Types of Purpura

There are several types of purpura, including:

• Henoch-Schonlein purpura: an inflammation of the small blood vessels in the skin, joints, bowels, and kidneys [3].
• Purpura hemorrhagica: a noncontagious disease in horses characterized by acute bleeding from small blood vessels [4].
• Senile purpura: a condition caused by increased vessel fragility due to connective tissue damage or atrophy in the dermis, often resulting from chronic sun exposure [5].

Causes and Symptoms

Purpura can be caused by various factors, including:

• Lack of normal platelets: not enough platelets are available to plug damaged vessels or prevent leakage from minor injuries [6].
• Increased vessel fragility: due to connective tissue damage or atrophy in the dermis [5].

Symptoms of purpura vary but often include purple-colored spots and patches on the skin, as well as bleeding from small blood vessels.

References

[1] Context result 1 [2] Context result 2 [3] Context result 4 [4] Context result 5 [5] Context result 8 [6] Context result 7

Purpura Signs and Symptoms

Purpura, a condition characterized by purple, red, or brown spots on the skin, can manifest in various ways. The following are some common signs and symptoms associated with purpura:

• Skin manifestations: Purple spots (purpura) on the skin, which can be flat or raised, and may appear as small dots or larger patches [1][2]
• Abdominal pain: Pain in the abdominal area, which can range from mild to severe [3][4]
• Joint pain: Aching or pain in the joints, particularly in the legs [3]
• Fever: Elevated body temperature, which can be a symptom of underlying infections or conditions [1][2]
• Gastrointestinal symptoms: Diarrhea, nausea, and vomiting, which can indicate gastrointestinal involvement [5][6]

Other possible symptoms

In some cases, purpura may also be associated with:

• Fatigue or exhaustion: Feeling tired or weak, particularly in children [7]
• Bleeding: Easy bruising or bleeding, which can be a sign of underlying blood disorders [8]

It's essential to note that the presence and severity of these symptoms can vary depending on the underlying cause of purpura. If you suspect you or someone else has purpura, it's crucial to consult with a healthcare professional for proper diagnosis and treatment.

References:

[1] Apr 13, 2022 — Purpura is purple, red or brown spots and patches on your skin. [2] Sep 13, 2023 — Purpura is flat purple, red, or brown spots on your skin or inside of your mouth that develop when blood vessels leak under the surface. [3] Henoch-Schonlein Purpura. This disorder usually presents with red to purple bumps on the legs, often accompanied by aching in the joints and fever. [4] Sep 5, 2023 — Thrombocytopenic purpura causes tiny purple or dark dots, and larger patches. [5] Jan 4, 2019 — It can manifest in various ways from very small petechiae to large bruises, but despite its presentation, “they are all manifestations of the ... [6] Symptoms include a purple spotted skin rash, abdominal pain and gastrointestinal upsets such as diarrhoea. [7] Result: skin rashes | tiredness or exhaustion | bleeding [8] Symptoms include a purple spotted skin rash, abdominal pain and gastrointestinal upsets such as diarrhoea. Children (particularly boys) are most commonly ...

Diagnostic Tests for Purpura

Purpura, a condition characterized by purple spots or patches on the skin, can be diagnosed through various tests. Here are some of the diagnostic tests used to confirm a diagnosis of purpura:

• Complete Blood Count (CBC): A CBC test checks the number of red blood cells, white blood cells, and platelets in your blood [3]. This test is often used to diagnose conditions such as thrombotic thrombocytopenic purpura (TTP) [2].
• Blood Smear: A blood smear test examines a sample of blood under a microscope to check for abnormalities in the blood cells [7].
• Bone Marrow Exam: In some cases, a bone marrow exam may be necessary to rule out other conditions and confirm a diagnosis of purpura [7].
• Bilirubin Test: A bilirubin test measures the level of bilirubin in the blood, which can indicate liver function and help diagnose conditions such as TTP [3].
• Skin Biopsy: A skin biopsy may be performed to examine a sample of skin tissue under a microscope to confirm a diagnosis of purpura [6].

It's worth noting that no single test can prove a diagnosis of purpura, and a combination of tests and medical history is often used to make a diagnosis [7].

Treatment Options for Purpura

Purpura, a condition characterized by purple spots or patches on the skin due to bleeding under the skin, can be treated with various medications and in some cases, surgery.

• Immunosuppressive Medicines: In some cases, immunosuppressive medicines such as rituximab (Rituxan) or azathioprine (Azasan) may be prescribed to stop the immune system from destroying platelets [1].
• Medications to Increase Platelet Count: Treatment might include medicines to increase platelet count, which can help prevent further bleeding episodes [3].
• Surgery: In severe cases, surgery to remove the spleen, known as a splenectomy, may be necessary to treat purpura [2][3].

Newer Agents

Newer agents such as fostamatinib (Tavalisse) have been approved for use in treating purpura in patients who haven't responded to other treatments [4].

Other Treatment Options

In addition to medications and surgery, other treatment options may include chemotherapy, antiviral drugs, steroid medications, antibiotics, and corticosteroids. Corticosteroids can help reduce inflammation and prevent further bleeding episodes [7].

It's essential to consult a healthcare provider for proper diagnosis and treatment of purpura.

References: [1] Apr 13, 2022 [2] Mar 30, 2018 [3] Jun 8, 2023 [4] Mar 13, 2024 [7] This can include options such as chemotherapy, antiviral drugs, steroid medications, antibiotics, and surgery.

Differential Diagnosis of Purpura

Purpura, a condition characterized by discoloration of the skin or mucous membranes due to hemorrhage from small blood vessels [3], has a broad differential diagnosis. The following are some key considerations:

• Vascular (non-thrombocytopenic) causes: These include:
  • Henoch-Schönlein purpura, a form of vasculitis that affects the skin and other organs [9]
  • Polyarteritis nodosa, a condition characterized by inflammation of medium-sized arteries
  • Juvenile rheumatoid arthritis, which can cause purpura in some cases
• Thrombocytopenic causes: These include:
  • Thrombotic thrombocytopenic purpura (TTP), a rare blood disorder that affects platelet count and function
  • Hemolytic-uremic syndrome, a condition characterized by hemolysis, thrombocytopenia, and renal failure
• Infectious causes: These include:
  • Chronic meningococcemia, which can cause palpable purpura in some cases [8]
  • Gonococcemia, a rare but serious infection caused by Neisseria gonorrhoeae
  • Subacute bacterial endocarditis, an infection of the heart valves that can cause purpura
• Other causes: These include:
  • Trauma or physical abuse, which can cause bruising and purpura [5]
  • Iatrogenic disorders, such as those caused by anticoagulant therapy or other medications
  • Hepatic insufficiency with poor procoagulant synthesis, a rare condition that can cause bleeding and purpura

It's worth noting that the differential diagnosis of purpura in neonates is extensive and includes hematological disorders, infections, trauma, and iatrogenic disorders [4]. In elderly patients without a previous history of bleeding or known underlying disease, the differential diagnosis may include conditions such as coumarin necrosis, psychogenic purpura, and physical abuse [6].

References:

[3] Signs and symptoms of purpura vary according to its cause.

[4] The differential diagnosis of purpura is extensive in neonates.

[5] Physical abuse can cause bruising and purpura.

[6] Diagnostic approach for purpura in elderly patients without a previous history of bleeding or known underlying disease.

[7] Purpura is a sign rather than a diagnosis, and a cause must be sought.

[8] Palpable purpura is seen in chronic meningococcemia, gonococcemia, and subacute bacterial endocarditis.

[9] Key differential diagnostic considerations of Henoch-Schönlein purpura.