Purpura

{{Short description|Skin discoloration due to underlying bleeding}}

{{Other uses}}

{{Infobox medical condition (new)

| name = Purpura

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| image = HSP Vasculitis.jpg

| caption = Petechiae and purpura on the lower limb due to infection-associated vasculitis

| field = Dermatology, hematology

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Purpura ({{IPAc-en|ˈ|p|ɜːr|p|jʊər|ə}}{{cite web |url=https://www.lexico.com/en/definition/purpura |archive-url=https://web.archive.org/web/20191017134333/https://www.lexico.com/en/definition/purpura |url-status=dead |archive-date=October 17, 2019 |title = PURPURA English Definition and Meaning {{!}} Lexico.com}}) is a condition of red or purple discolored spots on the skin that do not blanch on applying pressure. The spots are caused by bleeding underneath the skin secondary to platelet disorders, vascular disorders, coagulation disorders, or other causes.{{cite web|title=UCSF Purpura Module|url=http://www.dermatology.ucsf.edu/education_training/140.01ClinicalDermatology/Module.8.Purpura%20Module%20REVISED2.pdf|url-status=dead|archive-url=https://web.archive.org/web/20131002064433/http://www.dermatology.ucsf.edu/education_training/140.01ClinicalDermatology/Module.8.Purpura%20Module%20REVISED2.pdf|archive-date=2013-10-02}} They measure 3–10 mm,{{Cite book|title=Clinical Laboratory Hematology|last=McKenzie, Shirlyn B.|others=Williams, Joanne Lynne; Landis-Piwowar, Kristin|year=2014|isbn=978-0133076011|edition=3rd|location=Boston|pages=665|oclc=878098857}} whereas petechiae measure less than 3 mm, and ecchymoses greater than 1 cm.{{Cite book|title=Robbins basic pathology|others=Kumar, Vinay; Abbas, Abul K.; Aster, Jon C.; Perkins, James A.|isbn=978-0323353175|edition=10th|location=Philadelphia, Pennsylvania|pages=101|oclc=960844656|date = 2017-03-28}}

Purpura is common with typhus and can be present with meningitis caused by meningococci or septicaemia. In particular, meningococcus (Neisseria meningitidis), a Gram-negative diplococcus organism, releases endotoxin when it lyses. Endotoxin activates the Hageman factor (clotting factor XII), which causes disseminated intravascular coagulation (DIC). The DIC is what appears as a rash on the affected individual.

Classification

Purpura are a common and nonspecific medical sign; however, the underlying mechanism commonly involves one of:

Cases of psychogenic purpura are also described in the medical literature,{{cite journal |vauthors=Anderson JE, DeGoff W, McNamara M |title=Autoerythrocyte sensitization (psychogenic purpura): a case report and review of the literature |journal=Pediatric Emergency Care |volume=15 |issue=1 |pages=47–48 |year=1999 |pmid=10069314 |doi=10.1097/00006565-199902000-00014}} some claimed to be due to "autoerythrocyte sensitization". Other studies{{cite journal |vauthors=Lotti T, Benci M, Sarti MG, Teofoli P, Senesi C, Bonan P, etal |title=Psychogenic purpura with abnormally increased tPA dependent cutaneous fibrinolytic activity |journal=International Journal of Dermatology |volume=32| issue=7 |pages=521–23 |year=1993 |pmid=8340191 |doi=10.1111/j.1365-4362.1993.tb02840.x|s2cid=38433734 }} suggest the local (cutaneous) activity of tissue plasminogen activator can be increased in psychogenic purpura, leading to substantial amounts of localized plasmin activity, rapid degradation of fibrin clots, and resultant bleeding. Petechial rash is also characteristic of a rickettsial infection.

Etymology and pronunciation

The word purpura ({{IPAc-en|ˈ|p|ɜr|p|ɜr|ə}}) comes from Latin purpura, "purple", which came from ancient Greek πορφύρα. Purpura is a mass noun naming the condition or state, not the name of an individual spot (thus there is no *purpurum, *purpura or *purpura, *purpurae count declension).

See also

References

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