Classification & external resources
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.
This is common with typhus and can be present with meningitis caused by meningococcal meningitis or septicaemia.
Purpura is a common and unspecific symptom, however the underlying mechanism commonly involves one of the following:
- Platelet disorders
- 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
There are also cases of psychogenic purpura described in the medical literature, some claimed to be due to "autoerythrocyte sensitization". Other studies 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.
- ^ 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.
- ^ 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.
|Pathology: hematology (primarily C81-C96/200-208, D45-D47, D50-D77/280-289)|
|WBCs||hematological malignancy (lymphoma, leukemia, multiple myeloma), myeloproliferative disease, myelodysplastic syndrome|
-cytosis (Agranulocytosis, Leukocytosis, Lymphocytosis, Monocytosis) • -penia (Lymphopenia, Neutropenia)
|nutritional anemia: Iron deficiency anemia, Plummer-Vinson syndrome, Megaloblastic anemia (Pernicious anemia)|
hereditary hemolytic anemia: G6PD Deficiency, Thalassemia, Sickle-cell disease/trait, Hereditary spherocytosis, Hereditary elliptocytosis, Hereditary stomatocytosis
acquired hemolytic anemia: Autoimmune (Warm), HUS, MAHA, PNH, PCH
aplastic anemia: Acquired PRCA, Diamond-Blackfan anemia, Fanconi anemia • Sideroblastic anemia • Hemochromatosis
|Coagulation/platelets||coagulopathy: DIC • Hemophilia (A/VII, B/IX, C/XI, XIII) • Von Willebrand disease
Purpura: Henoch-Schönlein, ITP (Evans syndrome), TTP
primary hypercoagulable state: Protein C deficiency -
Protein S deficiency - Antithrombin III deficiency - Antiphospholipid syndrome - Factor V Leiden
other hemorrhagic conditions: Bernard-Soulier syndrome - Glanzmann's thrombasthenia - Grey platelet syndrome
|Histiocytosis||WHO-I Langerhans cell histiocytosis - non-Langerhans-cell histiocytosis/WHO-II (Juvenile xanthogranuloma, Hemophagocytic lymphohistiocytosis) - malignant histiocytic disorders/WHO-III (Acute monocytic leukemia, Malignant histiocytosis, Erdheim-Chester disease)|
|Other||Asplenia/hyposplenism - Methemoglobinemia|