Purpura (overview) D65-D69

The term purpura in the narrower sense refers to the seeding of small spots of blood in the skin. Skin hemorrhages (hemorrhages) are a clinical phenomenon. Purpura is characterized by localized or disseminated, small-spotted or extensive, red, blue, blue-green or yellow-brown (diascopically non-blanchable) spots or palpable elevations (shades due to bleeding of different ages). Purpura can be triggered by a variety of causes.

Purpura can be flat(spot) or elevated(papule = palpable purpura), inflammatory (vasculitis) or non-inflammatory (e.g. due to a vasculopathy).

In a broader sense, independent diseases are also referred to as "purpura", which are associated with hemorrhages in the skin (e.g. purpura pigmentosa progressiva; purpura Schönlein-Henoch).

A distinction is made according to shape and size:

• Petechiae
• Ecchymoses
• Sugillations
• Haematomas
• Vibex (Vibes).

Aetiologically, a vascular (vessel wall damage) purpura can be distinguished from a purpura caused by coagulation disorders.

see also Coin rubbing

1. Cines DB, Blanchette VS (2002) Immune thrombocytopenic purpura. N Engl J Med 346: 995-1008
2. Hundeiker M et al (1977) Dermatological purple forms as early and late allergic reactions. Act Dermatol 3: 39-48
3. Moake JL (2002) Thrombotic microangiopathies. N Engl J Med 347: 589-600