Summary about Disease
Purpura refers to purple-colored spots and patches that occur on the skin, and in mucous membranes, including the lining of the mouth. These discolorations appear because small blood vessels have leaked blood under the skin. Purpura is not a disease itself, but rather a sign or symptom of an underlying condition. It can range in severity from minor, self-resolving cases to serious medical emergencies.
Symptoms
Flat, purple or red spots on the skin.
Spots may appear in clusters.
The spots don't turn white when pressed.
Bruises easily.
In some cases, blisters or raised bumps may develop.
May be accompanied by other symptoms depending on the underlying cause (e.g., fever, joint pain, fatigue).
Causes
Purpura can be caused by a variety of factors including:
Blood disorders: Thrombocytopenic purpura (ITP, TTP), Henoch-Schönlein purpura (HSP), leukemia, and other blood clotting disorders.
Infections: Meningitis, sepsis, viral infections (e.g., cytomegalovirus).
Medications: Certain drugs can cause thrombocytopenia (low platelet count), leading to purpura.
Autoimmune diseases: Lupus, rheumatoid arthritis.
Nutritional deficiencies: Vitamin C or K deficiency.
Injury: Trauma or injury to the skin can cause blood vessels to leak.
Vasculitis: Inflammation of blood vessels.
Amyloidosis: Build up of Amyloid proteins.
Medicine Used
The medicines used to treat purpura depend entirely on the underlying cause. Some examples include:
Corticosteroids: To suppress the immune system in autoimmune-related purpura (e.g., prednisone).
Intravenous Immunoglobulin (IVIG): Used in ITP to boost platelet counts.
Rituximab: Another medication used in ITP to target B cells.
Antibiotics: For purpura caused by bacterial infections.
Vitamin supplements: For nutritional deficiencies (e.g., vitamin C or K).
Immunosuppressants: For vasculitis or other autoimmune conditions.
Platelet transfusions: In severe cases of thrombocytopenia.
Is Communicable
Purpura itself is generally not communicable. However, if the purpura is caused by an infectious agent (e.g., meningitis), that underlying infection may be communicable.
Precautions
Precautions depend on the underlying cause:
Good hygiene: Washing hands frequently can help prevent infections that might cause purpura.
Avoidance of triggers: If the purpura is caused by a medication, discontinue use of that medication (under medical supervision).
Protection from injury: Take precautions to avoid bumps or scrapes.
Manage underlying conditions: Properly managing autoimmune diseases or blood disorders can help prevent purpura.
Vaccination: Staying up-to-date on vaccinations can help prevent infections.
How long does an outbreak last?
The duration of a purpura outbreak depends entirely on the underlying cause and its severity. It can range from a few days (e.g., with a mild viral infection) to weeks or months (e.g., with a chronic autoimmune condition or severe infection). Some types of purpura may be recurrent.
How is it diagnosed?
Diagnosis typically involves:
Physical exam: Assessing the appearance and distribution of the purpura.
Medical history: Reviewing the patient's medications, past illnesses, and family history.
Blood tests: Complete blood count (CBC) to check platelet count, coagulation studies to assess clotting function, and blood smear to examine blood cells under a microscope.
Skin biopsy: A small skin sample may be taken to examine under a microscope.
Bone marrow aspiration and biopsy: In some cases, to evaluate the bone marrow's ability to produce blood cells.
Other tests: Depending on the suspected cause (e.g., antibody tests for autoimmune diseases, cultures for infections).
Timeline of Symptoms
The timeline of symptoms varies greatly depending on the cause.
Acute infections: Purpura may appear suddenly, along with other symptoms like fever, fatigue, and muscle aches.
Autoimmune conditions: The onset may be more gradual, with purpura developing over days or weeks, along with other autoimmune symptoms like joint pain or fatigue.
Medication-induced: Purpura may appear soon after starting a new medication or after prolonged use.
Injury: Purpura appears shortly after the trauma to the skin.
Important Considerations
Purpura can be a sign of a serious underlying condition, so it's important to seek medical attention for diagnosis and treatment.
Self-treating purpura is not recommended without knowing the underlying cause.
The treatment plan should be tailored to the specific cause of the purpura.
Individuals with bleeding disorders should be closely monitored.
Prompt treatment of underlying infections can prevent complications.
If taking medications that can cause purpura, discuss alternative options with your doctor.