Purpura

Henoch-Schonlein purpura on the lower legs

Henoch-Schonlein purpura on an infant's foot

Henoch-Schonlein purpura on an infant's legs

Henoch-Schonlein purpura on an infant's legs

Henoch-Schonlein purpura on the legs

Meningococcemia on the calves

Meningococcemia on the leg

Rocky mountain spotted fever on the foot

Meningococcemia associated purpura

Definition

Purpura is purple-colored spots and patches that occur on the skin, organs, and in mucus membranes, including the lining of the mouth.

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.

Read More

• Bleeding into the skin
• Platelet count

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.