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Purpura

 
Purpura

 
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Purpura (from the Latin, purpura, meaning "purple") is the appearance of red or purple discolorations on the skin
Skin

The skin is the outer covering of the body, also known as the epidermis. It is the largest organ of the integumentary system made up of multiple layers of epithelial biological tissue, and guards the underlying muscles, bones, ligaments and organ s....
 that do not blanch on applying pressure. They are caused by bleeding
Bleeding

Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood from the circulatory system. Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either through a natural opening such as the vagina, Mouth , nose, or anus, or through a break in the skin....
 underneath the skin
Skin

The skin is the outer covering of the body, also known as the epidermis. It is the largest organ of the integumentary system made up of multiple layers of epithelial biological tissue, and guards the underlying muscles, bones, ligaments and organ s....
. Purpura measure 0.3-1 cm, whereas petechiae
Petechia

A petechia , plural petechiae is a small red or purple spot on the body, caused by a minor hemorrhage .The most common cause of petechiae is through physical trauma such as a hard bout of coughing, vomiting or crying which can result in facial petechiae, especially around the eyes....
 measure less than 3 mm, and ecchymoses greater than 1 cm.

This is common with typhus
Typhus

Epidemic typhus is a form of typhus so named because the disease often causes epidemics following wars and natural disasters. The causative organism is Rickettsia prowazekii, transmitted by the human body louse ....
 and can be present with meningitis
Meningitis

Meningitis is a medical condition caused by inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges....
 caused by meningococcal meningitis or septicaemia.

ura is a common and unspecific medical sign, however the underlying mechanism commonly involves one of the following:



There are also cases of psychogenic purpura described in the medical literature, some claimed to be due to "autoerythrocyte sensitization." Other studies suggest, that local (cutaneous) activity of tPA
Tissue plasminogen activator

Tissue plasminogen activator is a protein involved in the breakdown of blood clots. Specifically, it is a serine protease found on endothelial cells, the cells that line the blood vessels....
 can be increased in psychogenic purpura, leading to substantial amounts of localized plasmin activity, rapid degradation of fibrin clots, and resultant bleeding.






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Purpura1
Purpura (from the Latin, purpura, meaning "purple") is the appearance of red or purple discolorations on the skin
Skin

The skin is the outer covering of the body, also known as the epidermis. It is the largest organ of the integumentary system made up of multiple layers of epithelial biological tissue, and guards the underlying muscles, bones, ligaments and organ s....
 that do not blanch on applying pressure. They are caused by bleeding
Bleeding

Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood from the circulatory system. Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either through a natural opening such as the vagina, Mouth , nose, or anus, or through a break in the skin....
 underneath the skin
Skin

The skin is the outer covering of the body, also known as the epidermis. It is the largest organ of the integumentary system made up of multiple layers of epithelial biological tissue, and guards the underlying muscles, bones, ligaments and organ s....
. Purpura measure 0.3-1 cm, whereas petechiae
Petechia

A petechia , plural petechiae is a small red or purple spot on the body, caused by a minor hemorrhage .The most common cause of petechiae is through physical trauma such as a hard bout of coughing, vomiting or crying which can result in facial petechiae, especially around the eyes....
 measure less than 3 mm, and ecchymoses greater than 1 cm.

This is common with typhus
Typhus

Epidemic typhus is a form of typhus so named because the disease often causes epidemics following wars and natural disasters. The causative organism is Rickettsia prowazekii, transmitted by the human body louse ....
 and can be present with meningitis
Meningitis

Meningitis is a medical condition caused by inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges....
 caused by meningococcal meningitis or septicaemia.

Classification

Purpura is a common and unspecific medical sign, however the underlying mechanism commonly involves one of the following:

  • Platelet disorders
    Platelet

    Platelets, or Thrombocyte, are small, irregularly shaped anuclear cells, 2-4?m in diameter, which are derived from fragmentation of precursor megakaryocytes....
    • Primary thrombocytopenic purpura
      Idiopathic thrombocytopenic purpura

      Idiopathic thrombocytopenic purpura is the condition of having a low platelet platelet count of no known cause . As most causes appear to be related to antibody against platelets, it is also known as immune thrombocytopenic purpura or immune-mediated thrombocytopenic purpura....
    • Secondary thrombocytopenic purpura
    • Post-transfusion purpura
      Post-transfusion purpura

      Post-transfusion purpura is an adverse reaction to a blood transfusion that occurs when the body produces alloantibodies to the introduced blood platelet antigens....
  • Vascular disorders
    • Microvascular injury, as seen in senile (old age) purpura, when blood vessels are more easily damaged
    • Hypertensive states
    • Deficient vascular support
    • Vasculitis
      Vasculitis

      Vasculitis refers to a heterogeneous group of disorders that are characterized by inflammatory destruction of blood vessels.Both arteries and veins are affected....
      , as in the case of Henoch-Schönlein purpura
      Henoch-Schönlein purpura

      Henoch-Sch?nlein purpura, also known as allergic purpura or anaphylactoid purpura and commonly abbreviated to HSP, is a systemic vasculitis characterized by deposition of immune complexes containing the antibody IgA in the skin and kidney....
  • Coagulation disorders
    Coagulopathy

    Coagulopathy is a medical term for a defect in the body's mechanism for blood clotting....
    • Disseminated intravascular coagulation
      Disseminated intravascular coagulation

      Disseminated intravascular coagulation , also known as consumptive coagulopathy, is a pathological activation of coagulation mechanisms that happens in response to a variety of diseases....
       (DIC)
  • Vitamin C deficiency - defect in collagen synthesis due to lack of hydroxylation of procollagen. It results in weakened capillary walls.


There are also cases of psychogenic purpura described in the medical literature, some claimed to be due to "autoerythrocyte sensitization." Other studies suggest, that local (cutaneous) activity of tPA
Tissue plasminogen activator

Tissue plasminogen activator is a protein involved in the breakdown of blood clots. Specifically, it is a serine protease found on endothelial cells, the cells that line the blood vessels....
 can be increased in psychogenic purpura, leading to substantial amounts of localized plasmin activity, rapid degradation of fibrin clots, and resultant bleeding. Petechial rash is also characteristic of a rickettsial infection.

See also

  • Petechia
    Petechia

    A petechia , plural petechiae is a small red or purple spot on the body, caused by a minor hemorrhage .The most common cause of petechiae is through physical trauma such as a hard bout of coughing, vomiting or crying which can result in facial petechiae, especially around the eyes....
  • Ecchymoses


External links

  • from American Academy of Family Physicians
    American Academy of Family Physicians

    The American Academy of Family Physicians was founded in 1947 to promote the science and art of general practitioner. It is one of the largest medical organizations in the United States, with more than 94,000 members....