Petechiae and Purpura Flashcards
what is purpura?
red/purple color from extravasation of blood into skin or mucus membranes
give the two types of macular purpura
ecchymoses and petechiae
what is the difference between ecchymoses and petechiae
echhymoses are larger than 5 mm and petechiae are smaller than 3 mm
is macular or palpable purpura a sign of vascular inflammation?
palpable purpura
what can you do to determine if purpura is from vasodilation or erythrocyte extravasation?
diascopy
what is a diascopy?
when you use glass to press on the redness
if the redness goes away with diascopy and comes back what is the cause?
vasodilation
if the redness remains with diascopy what is the cause
erythrocyte extrvasation
give the three features of scurvy
petechiae
hemorrhagic gingivitis
vit C deficiency
what two things are seen on skin with fulminant purpura?? and where on skin?
petechiae and large ecchymotic patches on extremities
what often occurs with fulminant purpura?
DIC
what is a common diagnosis that is the cause of fulminant purpura?
neisseria meningitidis leading to meningitis and sepsis
what is the initial rash in RMSF?
faint macules on wrist and ankles
what is the long standing rash with RMSF?
widespread petechiae on trunk extermities palms and soles
what is the triad seen in RMSF?
fever rash and tick bite
small vessel vasculitis leads to what on skin?
palpable purpura
small to medium vessel vasculitis leads to what on skin?
subcutaneous nodules, purpura, livedo reticularis, and maybe ulceration/necrosis
large vessel vasculitis leads to what on the skin?
claudication, ulceration and necrosis
what is the small vessel vasculitis to know?
Henoch Schonlein purpura
what are the small/medium vessel vasculitidies to know?
ANCA related…churg straus
micrscopic polyangitis
wegener granulomatosis
what is the medium vessel vasculitis to know?
polyarteritis nodosa
what is the large vessel vasculitis to know?
takayasu arteritis
what should you do to work up a purpuric lesion?
skin biopsy
what age gets henoch schenlein the most?
kids
what antibody deposits in henlock schenlein?
IgA
what can precede or cause henloch schenlein?
Strep infection
what other organ system should you check in henloch schenlein?
the renal system
how do you treat henloch schenlein?
supportive with maybe prednisone
how does henloch schenlein appear on the skin? what are other manifestations?
palpable purpura with arthritis, kidney disease and abdominal pain
how does polyarteritis nodosa appear on the skin?
multiple lower extremity erythematous subcutaneous nodules
what is polyarteritis nodosa associated with?
HBV, HCV, HIV, and parvovirus b19
what other manifestations can occur in polyarteritis nodosa?
fever
renal involvement
paresthesias
what is treatment for polyarteritis nodosa?
mainly supportive…maybe prednisone
