Skin hemorrhages

Alternative names

Blood spots; Purpura

Definition

Purplish discolorations in the skin produced by small bleeding vessels near the surface of the skin. Purpura may also occur in the mucous membranes (such as the lining of the mouth) and in the internal organs.

Considerations

Purpura by itself is only a sign of other underlying causes of bleeding.

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

Purpura may occur with either normal platelet counts (nonthrombocytopenic purpuras) or decreased platelet counts (thrombocytopenic purpuras). Platelets help maintain the integrity of the capillary lining and are important in the clotting process.

Common Causes

Conditions that cause purpura are grouped into two categories: nonthrombocytopenic and thrombocytopenic. Some common purpuras include:

NONTHROMBOCYTOPENIC PURPURAS

• pressure changes associated with vaginal delivery of an infant
  
• vasculitis such as Henoch-Schonlein purpura (anaphylactoid purpura)
  
• congenital cytomegalovirus
  
• congenital rubella syndrome (changes in the baby that can occur when a pregnant woman has rubella)
  
• drug-induced platelet dysfunction (some drugs can affect the action of platelets)
  
• senile purpura (the blood vessels become more fragile as a person ages)
  

THROMBOCYTOPENIC PURPURAS

• idiopathic thrombocytopenic purpura (ITP)
  
• immune neonatal thrombocytopenia (a disorder that can occur in infants whose mothers have ITP)
  
• platelet consumption in hemangioma
  
• drug-induced thrombocytopenia (some drugs can prevent the formation of platelets)
  
• meningococcemia (an infection caused by meningococcus bacteria)
  

Call your health care provider if

Any new purpura should be brought to your physician's attention.

What to expect at your health care provider's office

The medical history will be obtained and a physical examination performed.

Medical history questions documenting purpura may include: