Purpura

Definition

Purpura is purplish discolorations in the skin produced by small bleeding vessels near the surface of the skin. Purpura may also occur in the mucous membranes (such as the lining of the mouth) and in the internal organs.

Henoch-Schonlein purpura on the lower legs
Henoch-Schonlein purpura on an infant's foot
Henoch-Schonlein purpura on an infant's legs
Henoch-Schonlein purpura on an infant's legs
Henoch-Schonlein purpura on the legs
Meningococcemia on the calves
Meningococcemia on the leg
Rocky mountain spotted fever on the foot
Meningococcemia associated purpura

Alternative Names

Considerations

Purpura by itself is only a sign of other underlying causes of bleeding.

When purpura spots are very small, they are called petechiae. Large purpura are called ecchymoses.

Purpura may occur with either normal platelet counts (nonthrombocytopenic purpuras) or decreased platelet counts (thrombocytopenic purpuras). Platelets help maintain the integrity of the capillary lining and are important in the clotting process.

Common Causes

Conditions that cause purpura are grouped into 2 categories: nonthrombocytopenic and thrombocytopenic. Some common purpuras include:

NONTHROMBOCYTOPENIC PURPURAS

• Pressure changes associated with vaginal delivery of an infant
• Vasculitis such as Henoch-Schonlein purpura (anaphylactoid purpura)
• Congenital cytomegalovirus
• Congenital rubella syndrome (changes in the baby that can occur when a pregnant woman has rubella)
• Drug-induced platelet dysfunction (some drugs can affect the action of platelets)
• Senile purpura (the blood vessels become more fragile as a person ages)

THROMBOCYTOPENIC PURPURAS

• Idiopathic thrombocytopenic purpura (ITP)
• Immune neonatal thrombocytopenia (a disorder that can occur in infants whose mothers have ITP)
• Platelet consumption in hemangioma
• Drug-induced thrombocytopenia (some drugs can prevent the formation of platelets)
• Meningococcemia (an infection caused by meningococcus bacteria)

Call your health care provider if

Any new purpura should be brought to your physician's attention.

What to expect at your health care provider's office

The medical history will be obtained and a physical examination performed.

Medical history questions documenting purpura may include:

• Is this the first time you have had spots such as these?
• When did they develop?
• Are they small purplish or reddish dots (petechiae)?
• Do they look like bruises (ecchymoses)?
• What medications are being taken?
• What other medical problems have you had?
• Does anyone in your family have similar spots?
• What other symptoms are also present?

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Review Date:4/30/2005
Reviewed By: Jonathan Kantor, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.