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Purpura Updated 12/2010

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BASICS

  • Description
  • Etiology

DIAGNOSIS

  • Signs and Symptoms
  • Essential Workup
  • Tests
  • Differential Diagnosis

TREATMENT

  • Pre-hospital
  • Initial Stabilization
  • ED Treatment
  • Medication (Drugs)
  • In-patient Considerations

Ongoing Care

  • Follow-Up Recommendations
The following is an excerpt....
BASICS
Description
  • Skin lesions caused by extravasation of blood into the skin or subcutaneous tissue
  • Increased fragility of capillaries or dermal support
  • The resultant lesions do not blanch completely with pressure (as seen when pressing down through a glass slide).
  • Nomenclature varies by the size of the lesions:
    • Petechiae (<2 mm)
    • Purpuric lesions (2–10 mm)
    • Ecchymoses (>10 mm)
  • Color determined by depth and time of onset:
    • Red if superficial and of recent onset
    • Purple if deep
    • Deep purple, brown, orange, or blue-green with later presentations
  • Nonpalpable purpura:
    • Simple hemorrhage or microvascular occlusion with ischemic hemorrhage
    • Generally due to a platelet disorder:
      • Diminished production
      • Altered distribution
      • Increased destruction
      • Abnormal function
  • Palpable purpura:
    • Generally due to vasculitis:
      • Autoimmune, small-vessel leukocytoclastic vasculitis ...

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See Also
Images >
1
FIG. 86.3. A, B: Leukocytoclastic vasculitis. Palpable purpura of the lower extremities.Credit: Courtesy of Dr. Bethany Bergamo, Assistant Professor of Dermatology, University of Birmingham, Birmingham, Alabama.
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