Purpura is a lesion of the skin or mucous membranes. This lesion is characterized by a hemorrhagic nature and purple tint. This is due to an abnormal output of red blood cells out of the blood vessels, which then accumulate in the dermis. This may be secondary to several disorders, including an inflammation of the lining of blood vessels in the vascular purpura or a blood platelet deficiency called thrombocytopenic purpura. Among the causes of inflammation, there are various diseases such as infections, cancers, blood diseases, the taking certain of medications, and inflammatory diseases of the vessels. Purpura should not be confused with other signs such as bruising or skin telangiectasia: the difference lies in the fact that purpuric lesions do not disappear with vitropression, a firm pressure to the area in question. Purpura is a clinical sign requiring quick action. In children with meningeal syndrome with fever, neck pain and headaches
, search for purpura is a must, because its presence is a sign of purpura fulminans, which signifies the presence of Meningococcal meningitis
, whose treatment must be urgent.
Purpura occurs as follows:
- red or purple skin rash that can take different forms:
- ecchymotic with large lesions;
- petechial, in the form of points;
- vibices, a kind of linear streaks.
Meanwhile, signs pointing to the origin of purpura should be sought such as a meningeal syndrome or hemorrhagic signs, often in the gums. The location of purpura is also important to note.
The diagnosis of purpura is clinical, made in the presence of lesions whose main characteristic is the absence of disappearance with vitropression. To identify the cause, the most important thing is to urgently find the presence of hemorrhagic or meningeal signs. Apart from these signs, the treatment must be fast and guided by the nature of the injuries and their location.
In the case of purpura fulminans, rapid in expansion and associated with a meningeal syndrome, antibiotics will be started and emergency hospitalization is required. In the case of purpura with hemorrhagic signs, platelet transfusion may be necessary. Other treatments depend on the cause of the purpura.