Purpura

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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

Palpable Purpura
Petechiae

Both petechia and purpura do not blanch

  • Purpura subdivided into:
    • <2mm of hemorrhage: petechiae
    • >2mm of hemorrhage: ecchymoses

Differential Diagnosis

Petechiae/Purpura (by cause)

Petechiae/Purpura (by findings)

Evaluation

Rash visual diagnosis

Management

  • Management directed by underlying condition

Disposition

See Also

References

  1. Nguyen T and Freedman J. Dermatologic Emergencies: Diagnosing and Managing Life-Threatening Rashes. Emergency Medicine Practice. September 2002 volume 4 no 9.