What is purpura?
Purpura is the name given to the discolouration of the skin or mucous membranes due to haemorrhage from small blood vessels.
- Petechiae are small, purpuric lesions up to 2mm across
- Ecchymoses or bruises are larger extravasations of blood.
- Palpable purpura is purpura than can be felt, due to inflammation of the blood vessels (vasculitis)
- Pigmented purpura is a sign of petechial haemorrhages associated with capillaritis
Extravasated blood usually breaks down and changes colour over a few weeks from purple, orange, brown and even blue and green.
Classification of purpura
There are many different types of purpura. Their classification depends on the appearance or cause of the condition.
|Platelet disorders|| Thrombocytopaenic purpura—due to destruction of platelets
|Other coagulation disorders||
|Vascular disorders|| Non-thrombocytopaenic purpura—leakage of blood through the vessel wall
What are the signs and symptoms of purpura?
The signs and symptoms of purpura vary according to the type of purpura. The following broad generalisations may be made.
- Petechiae are usually present in thrombocytopaenic purpura. There may be some external bleeding and bruising.
- Coagulation defects usually present as large ecchymoses and external bleeding. Petechiae do not feature.
- Inflamed blood vessels (vasculitis) cause persistent and localised purpura with an erythematous inflammatory component. This may be palpable. Ecchymoses and external bleeding are uncommon.
Disseminated intravascular coagulation
What is the treatment for purpura?
The underlying cause of purpura should be identified and treated accordingly.
- Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications.
On DermNet NZ:
- Cutaneous small vessel vasculitis
- Topical steroids
- Disseminated intravascular coagulation
- Leukaemia cutis
- Non-accidental injury
Books about skin diseases:
See the DermNet NZ bookstore