Purpura: Difference between revisions
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==Background== | ==Background== | ||
*Palpable [[petechiae]] and purpura are a result of either perivascular inflammation (vasculitis) or infection. | |||
*Non-palpable petechiae usually occur in low platelet states such as [[ITP]] and [[DIC]] | |||
{{Rash red flags}} | |||
==Clinical Features== | |||
[[File:HSPVasc01.jpg| thumb|Palpable Purpura]] | |||
[[File:PetechiaeSkin.png| thumb|Petechiae]] | |||
''Both petechia and purpura do not blanch'' | |||
*Purpura subdivided into: | *Purpura subdivided into: | ||
**<2mm of hemorrhage: petechiae | **<2mm of hemorrhage: petechiae | ||
**>2mm of hemorrhage: ecchymoses | **>2mm of hemorrhage: ecchymoses | ||
== | ===[[Purpura]]l Rash=== | ||
[[File: | <gallery mode="packed"> | ||
File:Rocky Mountain Spotted Fever Rash.jpg|[[Rocky mountain spotted fever]] | |||
File:Henoch-schonlein-purpura.jpg|[[Henoch-Schonlein purpura]] | |||
</gallery> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Purpura DDX}} | {{Purpura DDX}} | ||
{{Purpura DDX by findings}} | |||
==Evaluation== | |||
{{Purpura rash images}} | |||
==Management== | |||
*Management directed by underlying condition | |||
==Disposition== | |||
==See Also== | ==See Also== | ||
*[[Rashes]] | *[[Rashes]] | ||
==References== | |||
<references/> | |||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Symptoms]] |
Revision as of 04:06, 27 November 2019
Background
- Palpable petechiae and purpura are a result of either perivascular inflammation (vasculitis) or infection.
- Non-palpable petechiae usually occur in low platelet states such as ITP and DIC
Rash Red Flags[1]
- Fever
- Toxic appearance
- Hypotension
- Mucosal lesions
- Severe pain
- Very old or young age
- Immunosuppressed
- New medication
Clinical Features
Both petechia and purpura do not blanch
- Purpura subdivided into:
- <2mm of hemorrhage: petechiae
- >2mm of hemorrhage: ecchymoses
Purpural Rash
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
- Trauma
Petechiae/Purpura (by findings)
- Febrile, toxic
- Palpable
- Meningococcemia
- Disseminated gonococcal infection
- Endocarditis
- Rocky mountain spotted fever
- HSP
- Non-palpable
- Palpable
- Afebrile, nontoxic
- Palpable
- Autoimmune vasculitis
- Non-palpable
- Palpable
Evaluation
Purpural Rash
Henoch-schonlein purpura (Palpable purpura)
Neonatal purpura fulminans
Management
- Management directed by underlying condition
Disposition
See Also
References
- ↑ Nguyen T and Freedman J. Dermatologic Emergencies: Diagnosing and Managing Life-Threatening Rashes. Emergency Medicine Practice. September 2002 volume 4 no 9.