Purpura

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Purpura Classification and external resources
ICD-10	D69.
ICD-9	287
DiseasesDB	25619
MeSH	D011693

WikiDoc Resources for Purpura
Articles
Most recent articles on Purpura Most cited articles on Purpura Review articles on Purpura Articles on Purpura in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Purpura Images of Purpura Photos of Purpura Podcasts & MP3s on Purpura Videos on Purpura
Evidence Based Medicine
Cochrane Collaboration on Purpura Bandolier on Purpura TRIP on Purpura
Clinical Trials
Ongoing Trials on Purpura at Clinical Trials.gov Trial results on Purpura Clinical Trials on Purpura at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Purpura NICE Guidance on Purpura NHS PRODIGY Guidance FDA on Purpura CDC on Purpura
Books
Books on Purpura
News
Purpura in the news Be alerted to news on Purpura News trends on Purpura
Commentary
Blogs on Purpura
Definitions
Definitions of Purpura
Patient Resources / Community
Patient resources on Purpura Discussion groups on Purpura Patient Handouts on Purpura Directions to Hospitals Treating Purpura Risk calculators and risk factors for Purpura
Healthcare Provider Resources
Symptoms of Purpura Causes & Risk Factors for Purpura Diagnostic studies for Purpura Treatment of Purpura
Continuing Medical Education (CME)
CME Programs on Purpura
International
Purpura en Espanol Purpura en Francais
Businness
Purpura in the Marketplace Patents on Purpura
Experimental / Informatics
List of terms related to Purpura

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Purpura (from the Latin, purpura, meaning "purple") is the appearance of red or purple discolorations on the skin, caused by bleeding underneath the skin. Small spots are called petechiae, while large spots are called ecchymoses.

This is common with typhus and can be present with meningitis caused by meningococcal meningitis or septicaemia.

Classification

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

• Platelet disorders
  • Primary thrombocytopenic purpura
  • Secondary thrombocytopenic purpura
• Vascular disorders
  • Microvascular injury, as seen in senile (old age) purpura, when blood vessels are more easily damaged
  • Hypertensive states
  • Deficient vascular support
  • Vasculitis, as in the case of Henoch-Schönlein purpura
• Coagulation disorders
  • Disseminated intravascular coagulation (DIC)

There are also cases of psychogenic purpura described in the medical literature,^[1] some claimed to be due to "autoerythrocyte sensitization". Other studies^[1] suggest, that local (cutaneous) activity of tPA can be increased in psychogenic purpura, leading to substantial amounts of localized plasmin activity, rapid degradation of fibrin clots, and resultant bleeding.

Petechial spots over the back

Diagnosis

History and Symptoms

• present illness
• medicinal history
• system review
• CNS symptoms

Laboratory Findings

• Labs include

• ANA
• Blood cultures
• BUN / Creatinine
• CBC with differential
• C-reactive protein
• ESR
• PT/PTT/INR
• urinalysis
• LFTs
• Rheumatoid factor

Differential Diagnosis of Causes of Purpura

In alphabetical order. ^{[1] [1]}

• Allopurinol
• Atropine
• "Blueberry muffin baby"
• Child abuse
• Chloral hydrate
• Chronic stasis
• Churg - Strauss syndrome
• Cimetidine
• Corticosteroids
• Coxsackie Virus
• Disseminated Intravascular Coagulation
• Echo Virus
• Ehlers-Danlos syndrome
• Factitious purpura
• Factor VIII deficiency
• Factor IX deficiency
• Gardner-Diamond Syndrome
• Gold
• Hemolytic Uremic Syndrome
• Henoch - Schonlein Purpura
• Hepatitis B
• Hereditary hemorrhagic telangiectasia
• Hodgkin's Lymphoma
• Hydralazine
• Iodine
• Ketoconazole
• Leukocytoclastic vasculitis
• Liver Disease
• Lupus Erythematosus
• Measles
• Meningococcemia
• Myeloma
• Penicillin
• Phenytoin
• Platelet dysfunction
• Polyarteritis Nodosa
• Propylthiouracil
• Quinidine
• Religious rituals
• Rheumatoid Arthritis
• Rocky Mountain Spotted Fever
• Scurvy
• Scarlet Fever
• Sjogren's Syndrome
• Septic emboli
• Serum sickness
• Strangulation
• Subacute bacterial endocarditis
• Sulfonamides
• Tetracycline
• Thiazides
• Thrombocytopenia
• Typhoid
• Vitamin K deficiency
• Violent coughing
• Vomiting
• Von Willebrand's Disease
• Wegener's Granulomatosis

Treatment

Acute Pharmacotherapies

• Infections

• RMSF - doxycycline
• Meningococcemia - ceftriaxone

Chronic Pharmacotherapies

• Autoimmune disease

• methotrexate
• cyclosporine
• azathioprine
• mycopheolate mofetil

Primary Prevention

• Discontinue contributory medication
• Sun protection
• Avoid trauma

References

Further reading

• Evaluating the Child with Purpura from American Academy of Family Physicians

v • d • e Pathology: hematology, myeloid hematologic disease (primarily D50-D77, 280-289)
RBCs/ hemoglobinopathy	+ Polycythemia - Macrocytosis - Anemia Nutritional Iron deficiency anemia (Plummer-Vinson syndrome), Megaloblastic anemia (Pernicious anemia) Hemolytic Hereditary enzyme: G6PD Deficiency - Pyruvate kinase deficiency - Triosephosphate isomerase deficiency hemoglobin: Thalassemia - Sickle-cell disease/trait membrane: Hereditary spherocytosis - Hereditary elliptocytosis - Hereditary stomatocytosis Acquired Autoimmune (Warm, Cold), HUS, MAHA, PNH, PCH, Myelophthisic Aplastic Acquired PRCA, Diamond-Blackfan anemia, Fanconi anemia, Sideroblastic anemia Blood tests Normocytic - Microcytic - Macrocytic - Normochromic - Hypochromic Other Methemoglobinemia
Coagulation/platelets/ coagulopathy/ bleeding diathesis	+ Hypercoagulability primary: Antithrombin III deficiency - Protein C deficiency/Activated protein C resistance/Protein S deficiency/Factor V Leiden - Hyperprothrombinemia acquired: DIC (Congenital afibrinogenemia, Purpura fulminans) - autoimmune (Antiphospholipid) Other Essential thrombocytosis - clotting factor: Hemophilia (A/VIII, B/IX, C/XI) • Von Willebrand disease • Hypoprothrombinemia/II - XIII platelet function: Bernard-Soulier syndrome - Glanzmann's thrombasthenia - Gray platelet syndrome - May Hegglin anomaly - Pelger-Huet anomaly Purpura: Henoch-Schönlein, ITP (Evans syndrome), TTP Thrombocytopenia (Heparin-induced thrombocytopenia)
Monocytes/ macrophages	+ Histiocytosis WHO-I (Langerhans cell histiocytosis) WHO-II/non-Langerhans-cell (Juvenile xanthogranuloma, Hemophagocytic lymphohistiocytosis) WHO-III/malignant (Acute monocytic leukemia, Malignant histiocytosis, Erdheim-Chester disease) Other Chronic granulomatous disease -cytosis: Monocytosis - -penia: Monocytopenia
Granulocytes	+ -cytosis: granulocytosis (Neutrophilia, Eosinophilia, Basophilia) - -penia: Granulocytopenia/agranulocytosis (Neutropenia/Kostmann syndrome, Eosinopenia, Basopenia)
See also hematological malignancy and immune disorders

v • d • e WikiDoc Research Resources for Purpura
Articles on Purpura	Most recent articles on Purpura • Most cited articles on Purpura • Review articles on Purpura • Articles on Purpura in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Purpura	Powerpoint slides on Purpura • Images of Purpura • Photos of Purpura • Podcasts & MP3s on Purpura • Videos on Purpura
Evidence Based Medicine Regarding Purpura	Cochrane Collaboration on Purpura • Bandolier on Purpura • TRIP on Purpura
Cost Effectiveness of Purpura	Cost Effectiveness of Purpura
Clinical Trials Involving Purpura	Ongoing Trials on Purpura at Clinical Trials.gov • Trial results on Purpura • Clinical Trials on Purpura at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Purpura	US National Guidelines Clearinghouse on Purpura • NICE Guidance on Purpura • NHS PRODIGY Guidance • FDA on Purpura • CDC on Purpura
Textbook Information on Purpura	Books and Textbook Information on Purpura
Pharmacology Resources on Purpura	Dosing of Purpura • Drug interactions with Purpura • Side effects of Purpura • Allergic reactions to Purpura • Overdose information on Purpura • Carcinogenicity information on Purpura • Purpura in pregnancy • Pharmacokinetics of Purpura •
Genetics, Pharmacogenomics, and Proteinomics of Purpura	Genetics of Purpura • Pharmacogenomics of Purpura • Proteomics of Purpura
Newstories on Purpura	Purpura in the news • Be alerted to news on Purpura • News trends on Purpura
Commentary on Purpura	Blogs on Purpura
Patient Resources on Purpura	Patient resources on Purpura • Discussion groups on Purpura • Patient Handouts on Purpura • Directions to Hospitals Treating Purpura • Risk calculators and risk factors for Purpura
Healthcare Provider Resources on Purpura	Symptoms of Purpura • Causes & Risk Factors for Purpura • Diagnostic studies for Purpura • Treatment of Purpura
Continuing Medical Education (CME) Programs on Purpura	CME Programs on Purpura
International Resources on Purpura	Purpura en Espanol • Purpura en Francais
Business Resources on Purpura	Purpura in the Marketplace • Patents on Purpura
Informatics Resources on Purpura	List of terms related to Purpura

de:Purpura fr:Purpura

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