Purpura syndromes

"Purpura" refers to a polyetiological clinical picture characterized by haemorrhages of the skin.

The onset of purpura can be acute or chronic and insidious.

Purpura can be localized or disseminated, small spots or extensive.

A single purpura lesion can be flat (spot) or elevated (papule/plaque = 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 bleeding into the skin (e.g. purpura pigmentosa progressiva; purpura Schönlein-Henoch).

• Potentially hemorrhagic exanthema:
  • Scarlet fever, toxic
  • Hemorrhagic measles
  • Gloves and socks syndrome, papulopurpuric
  • Hemorrhagic fever syndromes
  • Hemorrhagic urticaria
  • Pemphigoid, bullous
  • Hemorrhagic fever.
• Skin diseases with hemorrhages:
  • Abt-Letterer-Siwe disease
  • Ecchymosis syndrome, painful
  • Leukemia, myeloid of the skin
  • Edema, infantile, acute, hemorrhagic
  • Epidermolysis
  • Hidroa vacciniformia
  • Kaposi's sarcoma.
• Vasculitic purpura:
  • Vasculitis, leukocytoclastic
  • Schönlein-Henoch purpura
  • Purpura in dysproteinemias (see e.g. below purpura in cryofibrinogenemia; purpura hyperglobulinemica)
  • Purpura pigmentosa progressiva and variants (purpua anularis teleangiectodes, lichen aureus, etc.),
• Vascular wall damage, congenital:
  • Ehlers-Danlos syndrome
  • Epidermolysis
• Vascular wall damage, acquired (endogenous or exogenous noxae):
  • Purpura actinica
  • Agranulocytosis
  • Amyloid purpura (Raccoon sign)
  • Purpura senilis
  • Cortisone purpura
  • Dermatomyositis
  • Diabetes mellitus
  • Chronic dialysis situation
  • Purpura, Cushing's purpura
  • Purpura, drug-induced
  • Splinter hemorrhages of the nails.
• Purpura in coagulation disorders:
  • Coumarin necrosis
  • Arthropod reactions, hemorrhagic purpura
  • Purpura, thrombocytopenic
  • Waterhouse-Friderichsen syndrome
  • Liver cirrhosis
  • Vitamin K deficiency
  • Protein C deficiency ( purpura fulminans)
  • Coin rubbing
• Pupura in local venous or lymphatic circulation disorders:
  • Chronic venous insufficiency (CVI)
  • Purpura jaune d'ocre
  • Acroangiodermatitis
  • Atrophie blanche
  • Lymphangioma circumscriptum
  • Lichen sclerosus et atrophicus.
• Purpura in bacteremia.

The "dermatological signal" purpura, requires further diagnostic clarification by laboratory values and gfls. by a skin biopsy.