Purpura, also known as skin haemorrhages or blood spots, is a skin condition in which bruise-like spots or patches appear on the skin. The spots appear reddish-purple or brownish-black, depending on the skin tone. This condition surfaces when the blood vessels underneath the skin burst or leak blood. It leads to the accumulation of blood, causing it to pool under the skin. It can also be seen on the mucus membranes like the throat, mouth, and organs.
Purpura can indicate serious medical conditions. Hence, proper diagnosis and treatment is a must. Refer to the section to get insight into the causes and treatment methods of purpura.
Types of Purpura
We have highlighted here the different types of purpura. Let’s have a look at them:
1. Petechiae
Petechiae are caused by tiny bleeds from capillaries or small blood vessels beneath the skin. These are generally flat, pinpoint-sized spots that appear on the mouth, inside the eyelids, legs, arms, etc. Endocarditis, strep throat, any damage to the skin from car accidents, immense sunburn, etc. can cause petechiae.
2. Purpura Simplex
Purpura simplex (PS), also known as pigmented purpuric dermatoses, results from fragile blood vessels. It refers to the condition of increased bruising and may appear on the thighs, buttocks, and upper arms. Purpura simplex is mostly a benign condition, often affecting women. Sun exposure, prior use of corticosteroids, etc., can lead to this condition.
3. Henoch-Schönlein Purpura (HSP)
HSP, also known as IgA vasculitis, refers to the condition in which the small blood vessels present in the joints, intestines, kidneys, and skin start bleeding and getting inflamed. It can affect anyone and can cause aching joints and abdominal pain. Symptoms include rash, digestive tract symptoms, swollen and sore joints, etc.
4. Senile Purpura
Senile purpura, also known as solar purpura or actinic purpura, is a benign skin condition that mostly impacts older adults. It results from the sunburn affecting the connective tissue of the skin. It appears on the hands, lower legs, and forearms. This condition is characterised as ecchymoses.
5. Nonthrombocytopenic
Conditions that can cause Nonthrombocytopenic are:
- Congenital disorders like telangiectasia or Ehlers-Danlos syndrome
- Weak blood vessels
- Extreme deficit of vitamin C
- Medications that affect the function of the platelet
- Inflammation in the blood vessels
- Scurvy
- Disorders affecting the process of blood clotting
6. Thrombocytopenic
Conditions that cause Thrombocytopenic Purpura:
- Certain medications that affect normal platelet count
- Blood transfusion
- Autoimmune diseases (like Systemic Lupus Erythematosus)
- Infections in the bloodstream
- Medications that impact blood clotting
- Rocky Mountain fever
- HIV or Hepatitis C
- Infections like Epstein-Barr, rubella, or cytomegalovirus
- Immune disorders (like immune thrombocytopenia)
What are the Causes of Purpura?
The causes of purpura vary depending on the specific type. Some common purpura causes are as follows:
1. Platelet Disorders
Idiopathic thrombocytopenic purpura (ITP), Immune thrombocytopenic purpura (ITP), and Thrombotic thrombocytopenic purpura (TTP) are the varied platelet disorders that cause purpura.
2. Trauma or Injury
Physical trauma or injury can damage the blood vessels underneath the skin. This type of purpura is often seen in elderly individuals with fragile skin. Traumatic purpura is accidental and happens when your skin suffers any pressure from accidents or trauma.
3. Infections
Acute infectious purpura fulminans is considered a life-threatening purpura, which is caused by the meningococcus. Even Varicella-zoster virus, Streptococci can cause purpura. Further, bacterial endocarditis, or viral infections, can also lead to purpura.
What are the Symptoms of Purpura Disease?
The primary symptom of purpura is the appearance of purple or red-coloured spots on the skin. The disease symptoms may vary depending on the underlying cause and may include:
- Abdominal pain
- Fatigue
- Easy bruising
- Joint pain or swelling
How to Heal Purpura?
The treatment and management of purpura depend on the underlying cause and severity of the condition. Here are some common treatment methods for purpura:
1. Observation and Symptom Management
In mild cases of purpura, especially with conditions like purpura simplex, no specific treatment may be necessary. The purpura rash often fades on its own without causing any complications.
2. Medications
Using Corticosteroids and immunosuppressive medicines prevents the platelets from getting destroyed. If corticosteroids are ineffective for a patient, they are given Rituximab (Rituxan).
Thrombopoietin receptor agonists like Romiplostim (Nplate) and Eltrombopag (Promacta) are used to treat Idiopathic Thrombocytopenic Purpura (ITP). These latest medications prompt the bone marrow to produce more platelets. Drugs like prednisone also help in elevating platelet levels.
3. Platelet Transfusion
In severe cases of purpura where the platelet count is critically low, platelet transfusion may be necessary to prevent excessive bleeding. This is typically reserved for situations where there is a high risk of life-threatening haemorrhage.
4. Treatment of Underlying Conditions
If purpura is a secondary manifestation of an underlying condition, such as an infection or autoimmune disorder, treating the underlying cause is crucial. Antibiotics may be prescribed for bacterial infections, while antiviral medications can be used for viral infections.
Conclusion
Purpura is not a medical condition in itself; it is actually a symptom of any underlying disease. It can be the size of a small dot, or it can also appear in large patches. It can result from minor injury or from severe medical conditions like infections and immune disorders. So, if you are experiencing severe or recurring purpura symptoms, then it is ideal to consult a doctor and start treatment before things get out of hand.
