Purpura: Difference between revisions
No edit summary |
|||
| (16 intermediate revisions by 2 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Palpable petechiae and purpura are a result of either perivascular inflammation (vasculitis) or infection. | *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 | *Non-palpable petechiae usually occur in low platelet states such as [[ITP]] and [[DIC]] | ||
{{Rash red flags}} | {{Rash red flags}} | ||
==Clinical Features== | ==Clinical Features== | ||
''Both petechia and purpura do not blanch'' | ''Both petechia and purpura do not blanch'' | ||
*Purpura subdivided into: | *Purpura subdivided into: | ||
| Line 14: | Line 13: | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Purpura DDX}} | {{Purpura DDX}} | ||
{{Purpura DDX by findings}} | |||
==Evaluation== | ==Evaluation== | ||
{{Purpura rash images}} | |||
==Management== | ==Management== | ||
*Management directed by underlying condition | |||
==Disposition== | ==Disposition== | ||
*Depends on underlying etiology | |||
==See Also== | ==See Also== | ||
| Line 28: | Line 32: | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Symptoms]] | |||
Revision as of 22:54, 9 September 2020
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
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
Petechiae
Henoch-schonlein purpura (Palpable purpura)
Neonatal purpura fulminans
Management
- Management directed by underlying condition
Disposition
- Depends on underlying etiology
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.