Purpura

• Alternative Names

  Blood spots; Skin hemorrhages

• Considerations

  Purpura occurs when small blood vessels under the skin leak.

  When purpura spots are very small, they are called petechiae. Large purpura are called ecchymoses.

  Platelets help the blood clot. A person with purpura may have normal platelet counts (nonthrombocytopenic purpuras) or decreased platelet counts (thrombocytopenic purpuras).

• Common Causes

  Nonthrombocytopenic purpuras may be due to:

  • Congenital cytomegalovirus
  • Congenital rubella syndrome
  • Drugs that affect platelet function
  • Fragile blood vessels (senile purpura)
  • Pressure changes that occur during vaginal childbirth
  • Inflammation of the blood vessels (vasculitis), such as Henoch-Schonlein purpura

  Thrombocytopenic purpura may be due to:

  • Drugs that prevent platelets from forming
  • Hemangioma
  • Idiopathic thrombocytopenic purpura (ITP)
  • Immune neonatal thrombocytopenia (can occur in infants whose mothers have ITP)
  • Meningococcemia
• Call your health care provider if

  Call your doctor for an appointment if you have signs of purpura.

• What to expect at your health care provider's office

  Your doctor will examine your skin and ask you questions about your medical history and symptoms, including:

  • Is this the first time you have had such spots?
  • When did they develop?
  • What color are they?
  • Do they look like bruises?
  • What medications do you take?
  • What other medical problems have you had?
  • Does anyone in your family have similar spots?
  • What other symptoms do you have?

  A skin biopsy may be done.

• References

  Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Philadelphia, Pa: WB Saunders; 2004:2410.

  Hoffman R, Benz EJ, Shattil SS, et al. Hematology: Basic Principles and Practice. 4th ed. Orlando, Fl: Churchill Livingstone; 2005.

Review Date: 4/17/2009

Reviewed By: Michael Lehrer, MD, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.