Purpura

Background

• Purpura subdivided into:
  • <2mm of hemorrhage: petechiae
  • >2mm of hemorrhage: ecchymoses

Rash Red Flags

• Fever
• Toxic appearance
• Hypotension
• Mucosal lesions
• Severe pain
• Very old or young age
• Immunosuppressed
• New medication

Clinical Features

Palpable Purpura

Differential Diagnosis

Petechiae/Purpura (by cause)

• Abnormal platelet count and/or coagulation
  • Septicemia
  • Idiopathic thrombocytopenic purpura (ITP)
  • Hemolytic uremic syndrome
  • Leukemia
  • Coagulopathies (e.g. hemophilia)
  • Henoch-Schonlein Purpura (HSP)
  • Acute hemorrhagic edema of infancy (AHEI)
• Hypersensitivity vasculitis
• Primary vasculitides
  • Wegener's
  • Microscopic polyangiitis
  • Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
• Secondary vasculitides
  • Henoch-Schonlein purpura
  • Connective tissue disorder
    • Systemic lupus erythematosus
  • Scurvy
  • Infectious disease
    • Hepatitis B
    • Hepatitis C
• Trauma

See Also

• Rashes