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Petechiae and Purpura

Purpura and Petechiae are both manifested by bleeding into the skin.  On the surface, purpura will appear as large purple patches about 1 to 5 mm in diameter.  Petechiae, on the other hand appear on the skin as tiny pinpoint rashes.  These usually appear on the shins but can appear in other parts of the body.  These disappear after a few days and turns to a brown color before it vanishes. 

These bruises are common among leukemia patients and on aging people.  There are several causes of petechiae.   Injury and trauma, radiation and chemotherapy, allergies, nutritional deficiencies, and bruises lead to the bleeding into the skin. It is also common to see petcheiae in newborn babies.  Purpura results when blood platelet count is low.  It can also result from damaged blood vessels.  Among the elderly, this is seen as the brown spots on the arm, and the hand.  

When the skin bleeding is caused by injury, applying an icepack can ease the bleeding, and the bruise will eventually go away in time.  If petechiae are caused by an infection, the patient is dosed with antibiotics.  If the condition is triggered by an allergy to medication, the medication should be immediately discontinued.  Patients exhibiting petechiae, and who have low platelet count oftentimes need platelet transfusion.  Cancer and leukemia patients may need surgery, radiation, and chemotherapy.  

The difference between petechiae and purpura can be determined by the application of pressure on the bruise.  If the bruising is caused by an abnormality in a blood vessel, the redness fades temporarily.  In purpura, when pressure is applied, the redness does not pale or fade.  Petechiae indicate some bleeding within the skin.  If the bleeding is deeper or beneath the skin, the bruise is caused by a spontaneous flow of blood from the blood vessel.
There are several considerations in evaluating patients with petechiae and purpura.  In looking at the history, the doctor has to determine the age of the child and the age of the first medical check-up for the condition.  The doctor will check for allergies, bone pain, and bleeding in other areas.  The doctor will also look to skin rashes or eczema.  Laboratory examinations will check the condition of the liver and the spleen.  The thumbs and the forearms will also be checked for discoloration.   

Petechiae and purpura are symptomatic of other diseases, like cancer and leukemia, and a host of other ailments.  One such condition is vasculitis or inflammation of the blood vessels in the skin.  The inflammation can also be manifested by the blood vessels or capillaries in the kidneys and in the bowel.  Bleeding in the intestines and the kidneys may also occur.  In rare cases, internal capillary bleeding can cause blockage in the intestines and surgery will be necessary.  Treatment of the underlying causes of the skin bleeding will cure petechiae and purpura.  

If you have petechiae or purpura, see a doctor immediately.  The doctor will examine your closely and order laboratory examinations to eliminate other conditions before giving his prescription.