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| | __NOTOC__ |
| | '''For patient information click [[Purpura (patient information)|here]]''' |
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| {{Infobox_Disease | | | {{Infobox_Disease | |
| Name = {{PAGENAME}} | | | Name = {{PAGENAME}} | |
| Image = Purpura.jpg | | | Image = Purpura.jpg | |
| Caption = | | | Caption = | |
| DiseasesDB = 25619 |
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| ICD10 = {{ICD10|D|69||d|65}} |
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| ICD9 = {{ICD9|287}} |
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| ICDO = |
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| OMIM = |
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| MedlinePlus = |
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| eMedicineSubj = |
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| eMedicineTopic = |
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| MeshID = D011693 |
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| }} | | }} |
| {{SI}} | | {{Purpura}} |
| {{CMG}} | | {{CMG}} |
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| {{Editor help}} | | {{SK}} Skin hemorrhages |
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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 [[petechia|petechiae]], while large spots are called [[ecchymoses]].
| | ==[[Purpura overview|Overview]]== |
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| This is common with [[typhus]] and can be present with [[meningitis]] caused by [[meningococcal]] meningitis or [[septicaemia]].
| | ==[[Purpura historical perspective|Historical Perspective]]== |
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| ==Classification== | | ==[[Purpura classification|Classification]]== |
| Purpura is a common and unspecific symptom, however the underlying mechanism commonly involves one of the following:
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| *[[Platelet|Platelet disorders]]
| | ==[[Purpura pathophysiology|Pathophysiology]]== |
| **[[idiopathic thrombocytopenic purpura|Primary thrombocytopenic purpura]]
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| **Secondary thrombocytopenic purpura
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| *Vascular disorders
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| **Microvascular injury, as seen in senile (old age) purpura, when blood vessels are more easily damaged
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| **Hypertensive states
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| **Deficient vascular support
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| **[[Vasculitis]], as in the case of [[Henoch-Schönlein purpura]]
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| *[[Coagulopathy|Coagulation disorders]]
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| **[[Disseminated intravascular coagulation]] (DIC)
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| There are also cases of psychogenic purpura described in the medical literature,<ref name="pmid10069314">{{cite journal |author=Anderson JE, DeGoff W, McNamara M |title=Autoerythrocyte sensitization (psychogenic purpura): a case report and review of the literature |journal=Pediatric emergency care |volume=15 |issue=1 |pages=47-8 |year=1999 |pmid=10069314 |doi=}}</ref> some claimed to be due to "autoerythrocyte sensitization". Other studies<ref name="pmid8340191">{{cite journal |author=Lotti T, Benci M, Sarti MG, Teofoli P, Senesi C, Bonan P, et al. |title=Psychogenic purpura with abnormallt cutaney increased tPA dependeny |journous fibrinolytic activital=Int J Dermatol |volume=32| issue=7 |pages=521-3 |year=1993 |pmid=8340191 |doi=}}</ref> 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.
| | ==[[Purpura causes|Causes]]== |
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| == Differential Diagnosis of Causes of {{PAGENAME}} in alphabetical order== | | ==[[Purpura differential diagnosis|Differentiating Purpura from other Diseases]]== |
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| In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
| | ==[[Purpura epidemiology and demographics|Epidemiology and Demographics]]== |
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| *[[Allopurinol]]
| | ==[[Purpura risk factors|Risk Factors]]== |
| *[[Atropine]]
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| *"[[Blueberry muffin baby]]"
| | ==[[Purpura natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| *Child abuse
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| *[[Chloral hydrate]]
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| *Chronic stasis
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| *[[Churg - Strauss syndrome]]
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| *[[Cimetidine]]
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| *[[Corticosteroids]]
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| *[[Coxsackie Virus]]
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| *[[Disseminated Intravascular Coagulation]]
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| *[[Echo Virus]]
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| *[[Ehlers-Danlos syndrome]]
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| *Factitious purpura
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| *[[Factor VIII deficiency]]
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| *Factor IX deficiency
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| *[[Gardner-Diamond Syndrome]]
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| *[[Gold]]
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| *[[Hemolytic Uremic Syndrome]]
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| *[[Henoch - Schonlein Purpura]]
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| *[[Hepatitis B]]
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| *[[Hereditary hemorrhagic telangiectasia]]
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| *[[Hodgkin's Lymphoma]]
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| *[[Hydralazine]]
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| *[[Iodine]]
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| *[[Ketoconazole]]
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| *[[Leukocytoclastic vasculitis]]
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| *[[Liver Disease]]
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| *[[Lupus Erythematosus]]
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| *[[Measles]]
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| *[[Meningococcemia]]
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| *[[Myeloma]]
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| *[[Penicillin]]
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| *[[Phenytoin]]
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| *[[Platelet]] dysfunction
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| *[[Polyarteritis Nodosa]]
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| *[[Propylthiouracil]]
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| *[[Quinidine]]
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| *Religious rituals
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| *[[Rheumatoid Arthritis]]
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| *[[Rocky Mountain Spotted Fever]]
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| *[[Scurvy]]
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| *[[Scarlet Fever]]
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| *[[Sjogren's Syndrome]]
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| *[[Septic emboli]]
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| *[[Serum sickness]]
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| *[[Strangulation]]
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| *[[Subacute bacterial endocarditis]]
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| *[[Sulfonamides]]
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| *[[Tetracycline]]
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| *[[Thiazides]]
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| *[[Thrombocytopenia]]
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| *[[Typhoid]]
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| *[[Vitamin K deficiency]]
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| *Violent coughing
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| *[[Vomiting]]
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| *[[Von Willebrand's Disease]]
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| *[[Wegener's Granulomatosis]]
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| ==Diagnosis== | | ==Diagnosis== |
| | [[Purpura history and symptoms|History and Symptoms]] | [[Purpura physical examination|Physical Examination]] | [[Purpura laboratory findings|Laboratory Findings]] | [[Purpura other diagnostic studies|Other Diagnostic Studies]] |
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| === History and Symptoms === | | ==Treatment== |
| *present illness
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| *medicinal history
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| *system review
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| *CNS symptoms
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| ===Physical examination===
| | [[Purpura medical therapy|Medical Therapy]] | [[Purpura primary prevention|Primary Prevention]] | [[Purpura secondary prevention|Secondary Prevention]] | [[Purpura cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Purpura future or investigational therapies|Future or Investigational Therapies]] |
| <gallery>
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| Image:Purpura1.jpg|Petechial spots over the back
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| </gallery>
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| === Laboratory Findings === | | ==Case Studies== |
| *Labs include
| | [[Purpura case study one|Case #1]] |
| :*[[ANA ]]
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| :*Blood cultures
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| :*[[BUN]] / [[Creatinine]]
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| :*[[CBC]] with differential
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| :*[[C-reactive protein]]
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| :*[[ESR]]
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| :*PT/[[PTT]]/[[INR]]
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| :*[[urinalysis]]
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| :*[[LFT]]s
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| :*[[Rheumatoid factor]]
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| == Treatment==
| | {{Hematology}} |
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| === Acute Pharmacotherapies ===
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| *Infections
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| :*RMSF - doxycycline
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| :*Meningococcemia - ceftriaxone
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| === Chronic Pharmacotherapies ===
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| *Autoimmune disease
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| :*[[methotrexate]]
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| :*[[cyclosporine]]
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| :*[[azathioprine]]
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| :*mycopheolate mofetil
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| == Primary Prevention ==
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| *Discontinue contributory medication
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| *Sun protection
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| *Avoid trauma
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| ==References==
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| <references/>
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| ==Further reading==
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| * [http://www.aafp.org/afp/20010801/419.html Evaluating the Child with Purpura] from [[American Academy of Family Physicians]]
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| {{Hematology}}
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| {{SIB}}
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| [[de:Purpura]]
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| [[fr:Purpura]] | | [[fr:Purpura]] |
| [[pt:Púrpura (sintoma)]] | | [[pt:Púrpura (sintoma)]] |
| [[ru:Пурпура]] | | [[ru:Пурпура]] |
| [[zh:紫斑]] | | [[zh:紫斑]] |
| | | {{WH}} |
| {{WikiDoc Help Menu}} | | {{WS}} |
| {{WikiDoc Sources}} | |
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| [[Category:Dermatology]] | | [[Category:Dermatology]] |
| [[Category:Hematology]] | | [[Category:Hematology]] |
| | [[Category:Medical signs]] |
| [[Category:Signs and symptoms]] | | [[Category:Signs and symptoms]] |
| [[Category:Physical examination]] | | [[Category:Physical examination]] |
| [[Category:Emergency medicine]] | | [[Category:Emergency medicine]] |
