Alternate Names: Blood spots; Skin hemorrhages

Considerations: Purpura by itself is only a sign of other underlying causes of bleeding.

When purpura spots are very small, they are called petechiae. Large purpura are called ecchymoses.

Purpura may occur with either normal platelet counts (nonthrombocytopenic purpuras) or decreased platelet counts (thrombocytopenic purpuras). Platelets help maintain the integrity of the capillary lining and are important in the clotting process.

Common Causes: Conditions that cause purpura are grouped into two categories: nonthrombocytopenic and thrombocytopenic.

NONTHROMBOCYTOPENIC PURPURAS

• pressure changes associated with vaginal delivery of an infant
• Henoch-Schonlein purpura (anaphylactoid purpura)
• congenital cytomegalovirus
• congenital rubella syndrome (changes in the baby that can occur when a pregnant woman has rubella)
• drug-induced platelet dysfunction (some drugs can affect the action of platelets)
• senile purpura (the blood vessels become more fragile as a person ages)

• idiopathic thrombocytopenic purpura (ITP)
• immune neonatal thrombocytopenia (a disorder that can occur in infants whose mothers have ITP)
• platelet consumption in cavernous hemangioma
• drug-induced thrombocytopenia (some drugs can prevent the formation of platelets)
• meningococcemia (an infection caused by meningococcus bacteria)

Home Care: Consult your health care provider.

Call If:

• purpura or petechiae are present and there is no known cause.

What To Expect: The medical history will be obtained and a physical examination performed.

Medical history questions documenting purpura may include:

• time pattern
  • Is this the first time you have had spots such as these?
  • When did they develop?
• type
  • Petechiae (small purplish or reddish dots)?
  • Ecchymoses (look like bruises)?
• other
  • What medications are being taken?
  • What is the past medical history?
  • What is the family history?
  • What other symptoms are also present?