Purpura
Blood spots; Skin hemorrhagesPurpura is purple-colored spots and patches that occur on the skin, and in mucus membranes, including the lining of the mouth.
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Considerations
Purpura occurs when small blood vessels leak blood under the skin.
Purpura measure between 4 and 10 mm (millimeters) in diameter. When purpura spots are less than 4 mm in diameter, they are called petechiae. Purpura spots larger than 1 cm (centimeter) are called ecchymoses.
Platelets help the blood clot. A person with purpura may have a normal platelet count (non-thrombocytopenic purpuras) or a low platelet counts (thrombocytopenic purpuras).
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Causes
Non-thrombocytopenic purpuras may be due to:
- Amyloidosis (disorder in which abnormal proteins build up in tissues and organs)
- Blood clotting disorders
- Congenital cytomegalovirus (condition in which an infant is infected with a virus called cytomegalovirus before birth)
- Congenital rubella syndrome
- Drugs that affect platelet function or clotting factors
- Fragile blood vessels seen in older people (senile purpura)
- Hemangioma (abnormal buildup of blood vessels in the skin or internal organs)
- Inflammation of the blood vessels (vasculitis), such as Henoch-Schönlein purpura, which causes a raised type of purpura
- Pressure changes that occur during vaginal childbirth
- Scurvy (vitamin C deficiency)
- Steroid use
- Certain infections
- Injury
Thrombocytopenic purpura may be due to:
- Drugs that reduce the platelet count
- Idiopathic thrombocytopenic purpura (ITP) -- a bleeding disorder
- Immune neonatal thrombocytopenia (can occur in infants whose mothers have ITP)
- Meningococcemia (bloodstream infection)
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When to Contact a Medical Professional
Call your health care provider for an appointment if you have signs of purpura.
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What to Expect at Your Office Visit
The provider will examine your skin and ask about your medical history and symptoms, including:
- Is this the first time you have had such spots?
- When did they develop?
- What color are they?
- Do they look like bruises?
- What medicines do you take?
- What other medical problems have you had?
- Does anyone in your family have similar spots?
- What other symptoms do you have?
A skin biopsy may be done. Blood and urine tests may be ordered to determine the cause of the purpura.
References
Dinulos JGH. Principles of diagnosis and anatomy. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 1.
Kitchens CS. Purpura and other hematovascular disorders. In: Kitchens CS, Kessler CM, Konkle BA, Streiff MB, Garcia DA, eds. Consultative Hemostasis and Thrombosis. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 10.