Purpura




(1)
Hôpital Universitaire de Strasbourg, Strasbourg, France

 




Abstract

There are several semiological variants of purpura, some of which have a diagnostic value:


There are several semiological variants of purpura, some of which have a diagnostic value:



  • Stellate and retiform purpura (cf. Figs. 14.​13, 14.​14, 14.​15, and 14.​16): thrombosing vasculopathy


  • Palpable (infiltrated) purpura (cf. Fig. 3.​15): vasculitis


  • Purpuric papulopustules (cf. Figs. 5.​9, 14.​20, and 12.​52): septicemias, particularly caused by gonococci


  • Perifollicular purpura: scurvy


  • Ecchymotic purpura accompanied by bleeding (cf. Figs. 3.​14, 14.​18, and 14.​19): disorders of primary hemostasis

Until proven otherwise, purpura should always be considered as a sign of a medical emergency, e.g., meningococcemia, endocarditis, and purpuras related to thrombocytopenia and/or disseminated intravascular coagulation. For teaching purposes, the causes of palpable purpuras are also illustrated in this chapter.


Table 23.1
Main causes of non-palpable purpura















Petechial lesion
Ecchymotic lesion (with or without petechiae)

Bacteremia and septicemia (particularly bacterial endocarditis)
Angioimmunoblastic lymphadenopathy

DIC (usually ecchymotic and gangrenous and/orretiform purpura)

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Oct 6, 2016 | Posted by in Dermatology | Comments Off on Purpura

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