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Other Names:
Blood Spots, Skin Hemorrhages, Purpuric Spots
Purpura

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Definition

Purpura is purplish or deep reddish discoloration or spots in the skin or the mucous membrane lining of the mouth. These spots are produced by damage to the tiny blood vessels that break (rupture) easily. These blood vessels are near the surface of the skin or the mucous membrane. Purpura may also occur in the internal organs due to bleeding of minute blood vessels. Very tiny (pinpoint) purpuric spots are called petechiae and larger ones are called ecchymoses.

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Types

  • Non-thrombocytopenic Purpura - The platelet count is normal.
  • Thrombocytopenic Purpura - The platelet count is decreased.

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Causes

  • Non-thrombocytopenic Purpura
    • Pressure changes during vaginal delivery

    • Henoch-Schonlein purpura or anaphylactoid purpura
      • Bacterial infection
      • Viral infections
      • Medications
      • Insect bites
      • Vaccinations

    • Platelet dysfunction due to medications like aspirin, ibuprofen, corticosteroids

    • Dietary supplements like fish oil, vitamin E, garlic, ginger and ginkgo can increase your risk of purpuric spots and ecchymoses if you are on anti-coagulant (blood thinner) treatment.

    • Vasculitis
      • Hepatitis C and B viruses
      • Polyarteritis nodosa.
      • Rheumatoid arthritis
      • Lupus
      • Sjögren's syndrome
      • Sometimes an allergic reaction to a medication,

    • Allergic reaction to a medication such as an antibiotic or diuretic

    • Senile purpura or aging associated purpura due to increased fragility of blood vessels as you get older
  • Thrombocytopenic Purpura
    • Idiopathic thrombocytopenic purpura (ITP)

    • Increased aggregation and consumption of platelets as seen in hemangioma

    • Medication induced thrombocytopenia due to lack of formation of platelets.

    • Meningococcemia

    • Autoimmune disorders, such as lupus or rheumatoid arthritis

    • Viral infections, such as mononucleosis and german measles (rubella)

    • Severe bacterial infections

    • Bone marrow disorders, such as leukemia, myelodysplastic syndrome

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Symptoms

  • Rashes and raised areas of skin.
  • Purplish or deep reddish purpuric spots on the buttocks, arms, legs and feet
  • Fever
  • Fatigue
  • Loss of appetite
  • Weight loss
  • Muscle and joint pain
  • Easy bruising
  • Frequent nosebleeds
  • Abdominal pain due to bleeding in the intestine and kidneys
  • Blood in the urine or stool

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Implications

Purpura by itself is only a sign of other underlying causes of bleeding such as a problem in blood-clotting mechanism or blood-related disease. Purpuric spots should be taken seriously if they appear for no apparent reason, if you are experiencing abnormal bleeding from other sites such as from your nose, gums or intestines, if the purpuric spots have appeared after you have started a new medication.

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What You Can Do

  • Treat the underlying cause or medical condition that might be causing the purpuric spots by following physician prescribed treatment.

  • Avoid trauma (such as bumping or pulling on skin areas) and protect your skin by wearing long sleeves.

  • Protect your skin from sun damage.

  • For purpura caused by medications, consult your physician discontinuing or substituting the medication.

  • Consult your physician on a regular basis to monitor your medication dosages and make any necessary changes or adjustments if you are taking anti-coagulant treatment.

  • Eat a variety of foods including a daily selection of whole-grain and enriched breads, cereals, grain products, vegetables, fruits, milk, cheese, yogurt, meats, poultry, fish, eggs, dried beans, peas and tofu to avoid dietary deficiencies.

  • Nutritional deficiencies of vitamins C, K, B12, folic acid and calcium can affect blood clotting.

  • Avoid dietary supplements like fish oil, vitamin E, garlic, ginger and ginkgo biloba particularly if you take a blood-thinning medication.

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Purpura