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Anderson JE, DeGoff W, McNamara M (1999). "Autoerythrocyte sensitization (psychogenic purpura): a case report and review of the literature". Pediatric Emergency Care. 15 (1): 47–48. doi: 10.1097/00006565-199902000-00014. PMID 10069314. Ehlers-Danlos syndromes refer to inherited conditions affecting the connective tissues. Connective tissue supports various structures in the body, including the: People who start treatment right away or have a mild case often make a full recovery. However, purpura can become chronic in severe cases or when treatment is delayed. You should see your doctor as soon as possible if you suspect you have purpura. Living with purpura The clinical condition may indicate further investigations, including blood culture and lumbar puncture. Diseases associated with purpuric rashes
Lifestyle treatments can also help since drugs such as aspirin prevent platelets from aggregating and clotting. Long-term use of strong steroids can cause widespread purpura and bruising, normally on extensor surfaces of the hands, arms and thighs. It is caused by atrophy of the collagen fibres supporting blood vessels in the skin. A similar appearance is also found in senile-type purpura. Blood transfusions These have been outlined in 'Differential diagnosis', above. Here are some points you may wish to bear in mind. Bacterial infections https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Henoch-Sch%C3%B6nlein-Purpura-HSPSelective reduction in megakaryocytes (eg, drugs such as co-trimoxazole, chemicals, viral infections). Several autoimmune conditions or health issues that cause irregular bleeding or affect blood clotting can cause purpura and petechiae. Among them are: Petechiae can develop in small clusters or patches, resembling a rash. This may spread over a larger area of skin or be confined to a single area. Petechiae can occur around or among purpura. Petechiae in children A person with thrombocytopenia has a low platelet count. The following types of purpuric rash may develop due to thrombocytopenia: Thrombotic thrombocytopenic purpura If a doctor suspects Henoch-Schönlein purpura, urine tests can assess kidney function by testing for protein and blood in the urine.
If invasive meningococcal disease is suspected, administer parenteral antibiotics immediately, but do not delay hospital admission Not all cases of purpura demand immediate treatment. Doctors often opt to watch the patient for other symptoms to see if they go away on their own. Children experiencing Henoch-Schönlein purpura are often likely to get better without treatment. Aplastic anaemia (anaemia caused by problems with production of the platelets and other blood cells by the bone marrow). straining while coughing, vomiting, lifting something heavy, exercising vigorously, or using the bathroom Petechial rashes can develop in children. According to estimates, 2.5% of children taken to the emergency room experience them as a symptom.
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Having inspected the skin and taken a history, it may be useful to return to a physical examination to reassess the purpuric rash and carry out a further systemic examination, looking for hepatomegaly/splenomegaly or neurological signs, for example. Be guided by your findings so far. Differential diagnosis [ 1]
Your healthcare provider will begin with an examination of your skin. They’ll discuss your medical history and any drugs or medications you’re taking. They’ll take note of the size and color of the purpura and ask you when they first appeared.
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ITP symptoms range from mild to severe, and some patients require no treatment. Those who do may benefit from drugs designed to boost platelet count or, in rare cases, the removal of the spleen. Thrombocytopenic purpura and petechiae: These occur due to conditions that cause the irregular destruction of blood platelets — cell fragments that help the blood clot. Autoimmune conditions or certain medications or infections can have this effect. This condition is characterized by mild scale overlying purpuric and petechial macules, papules, and patches. It is often pruritic, and the lesions can be extensive and may involve the trunk and arms in addition to the lower extremities. It typically self-resolves over many months. [19] Heparin-induced thrombocytopenia: Occurs when a negative reaction to the drug heparin makes your body clot too much. The type of treatment your doctor will prescribe depends on the cause of your purpura. Adults diagnosed with mild thrombocytopenic purpura may recover without any intervention.
Purpura is common with typhus and can be present with meningitis caused by meningococci or septicaemia. In particular, meningococcus ( Neisseria meningitidis), a Gram-negative diplococcus organism, releases endotoxin when it lyses. Endotoxin activates the Hageman factor (clotting factor XII), which causes disseminated intravascular coagulation (DIC). The DIC is what appears as a rash on the affected individual. Approximately half of people have signs or symptoms of other medical conditions. These can include:People with the vascular form of Ehlers-Danlos syndrome have skin that bruises very easily. This is because their blood vessels can split open. The person’s skin may also be so thin that small blood vessels are visible, especially on the upper chest and legs. If your type of purpura is causing severe bleeding, your doctor may give you an intravenous medication called intravenous immunoglobulin (IVIG). They may also give you IVIG if you need to increase your platelet count rapidly before surgery. This treatment is usually effective in increasing your platelet count, but the effect is usually only in the short term. It can cause side effects such as headache, nausea, and fever. Other drug therapies Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. These are the latest medications for the treatment of ITP. Both romiplostim ( Nplate) and eltrombopag ( Promacta) encourage the bone marrow to produce more platelets.
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