Purpura

  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 petechiae, while large spots are called ecchymoses.

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This is common with typhus and can be present with meningitis caused by meningococcal meningitis or septicaemia.

Classification

Purpura is a common and unspecific symptom, however the underlying mechanism commonly involves one of the following:

• Platelet disorders
  • Primary thrombocytopenic purpura
  • Secondary thrombocytopenic purpura
• Vascular disorders
  • Microvascular injury, as seen in senile(old age) purpura, when blood vessels are more easily damaged
  • Hypertensive states
  • Deficient vascular support
  • Vasculitis, as in the case of Henoch-Schönlein purpura
• Coagulation disorders
  • Disseminated intravascular coagulation (DIC)

There are also cases of psychogenic purpura described in the medical literature,^[1] some claimed to be due to "autoerythrocyte sensitization". Other studies^[2] suggest, that local (cutaneous) activity of tPA can be increased in psychogenic purpura (26), leading to substantial amounts of localized plasmin activity, rapid degradation of fibrin clots, and resultant bleeding.

References

1. ^ Anderson JE, DeGoff W, McNamara M (1999). "Autoerythrocyte sensitization (psychogenic purpura): a case report and review of the literature". Pediatric emergency care 15 (1): 47-8. PMID 10069314.
2. ^ Lotti T, Benci M, Sarti MG, Teofoli P, Senesi C, Bonan P, et al. (1993). "Psychogenic purpura with abnormally increased tPA dependent cutaneous fibrinolytic activity". Int J Dermatol 32 (7): 521-3. PMID 8340191.

Further reading

• Evaluating the Child with Purpura from American Academy of Family Physicians