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DERM > Petechiia, Purpura, and Vasculitis > Flashcards

Petechiia, Purpura, and Vasculitis Flashcards

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Dermatology Board Prep flashcards
1
Q

What is a hallmark sin for leukocytoclastic vasculitis?

A

palpable purpura

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2
Q

What is purpura?

A

non-blanchable, pink to purple macules/patches or papules caused by extravasated RBCs in skin or mucous membranes

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3
Q

What is Diascopy?

A

use of a glass slide to apply pressure to lesion in order to distinguish erythema secondary to vasodilation (will blanch) from erythrocyte extravasation.

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4
Q

What are the main causes of purpura?

A
  • Coagulation/clotting abnormalities
  • Leaky or abnormal blood vessels
  • Trauma/other causes
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5
Q

What are the two types of purpura?

A
  • Non-palpable purpura (generally non-inflammatory)

- Palpable purpura (sign of vascular inflammation)

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6
Q

Waht are the features of petechiae?

A
  • Small <3mm red or purple dots seen on dependent areas of the body
  • Painless
  • Non-palpable
  • Non-inflammatory
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7
Q

Who is more likely to have petechiae, hemophiciac or patient receiving chemo?

A

Patient receiving chemo (due to thrombocytopenia)

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8
Q

What are the two broad classes of petechiae causes?

A
  • Platelet related (low platelets or platelet dysfunction)

- Non-platelet releated (increase of capillary fragility or things that allow them to leak)

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9
Q

Patients with scurvy lack what vitamin?

A

Vitamin C (need this to make collagen–to protect tiny capillaries of the skin)

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10
Q

What are features of ecchymosis?

A
  • Larger areas of purpura (>5mm)
  • Can be on any area of the body
  • May/may not be painful/tender
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11
Q

What is the major cause of ecchymosis?

A

abnormality in coagulation (hyper OR hypocoagulable)

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12
Q

What are some causes of purpura related to anticoagulant + trauma?

A
  • DIC
  • Renal/hepatic dysfunction
  • Anticoagulant medications
  • Vitamin K deficiency
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13
Q

What are some causes of purpura related to poor dermal support?

A
  • Actinic damage
  • Amyloid
  • Steroid-induced atrophy
  • Trauma
  • Scurvy
  • Ehlers Danlos
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14
Q

What is linear purpura most likely due to?

A

blood pressure cuffs used on thrombocytopenic patients

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15
Q

What is Waldenstrom hypergammaglobulinemic purpura?

A

looks like little red marks on skin?

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16
Q

What is Henoch-Schonlein purpura?

A

most common form of systemic vasculitis in children (3-15) that follows preceding viral or bacterial infection that causes inflammation of superficial blood vessels

17
Q

How do you diagnose Henoch-Schonlein purpura?

A

punch biopsy (immune complexes in vessel walls contain IgA deposition)

18
Q

What are symptoms of Henoch-Schonlein purpura?

A

palpable purpura (that can blister), arthritis, abdominal pain, kidney disease

19
Q

Do adults get Henoch-Schonlein purpura?

A

Yes–they are at HIGHER risk of kidney involvement!

20
Q

Is vasculitis localized to the skin?

A

NO- can affect kidneys, lungs, CNS, and GI tract

21
Q

What ist he primary determinant in classification of vasculitis?

A

size of blood vessel

22
Q

List diseases with small vessel vasculitis.

A
  • Henoch Schonlein purpura
  • Infections (ex. meningococcemia)
  • Drug reactions
  • Autoimmune disease (ex. SLE)
  • Malignancy-associated vasculitis (ex. myelodysplasia)
  • Idiopathic/hypersensitivity vasculitis
23
Q

List diseases with “mixed” sized vasculities.

A

ANCA-associated:

  • Churg-Strauss
  • Microscopic polyangitis
  • Wegener’s granulomatosis

Cryoglobulinemia

24
Q

What is the medium vessel vasculitis?

A

polyarteritis nodosa

25
Q

What are large vessel vasculites?

A

Giant cell arteritis
Takayasu arteritis
Bahcet’s

26
Q

What are skin features of small vessel vasculitis?

A
  • Palpable purpura

- Blisters, less commonly hives

27
Q

What are skin features of medium vessel vasculitis?

A
  • Nodules, purpura, livedo reticularis/racemosa

- Ulcers, skin necrosis

28
Q

What are skin features of large vessel vasculitis?

A

Less likely to affect skin

29
Q

What are some features of polyarteritis nodosa?

A

mottling with subtle nodules (that are bigger vessels with LOTS of inflammation)

30
Q

What is retiform purpura?

A

Distinctive form of ecchymosis with a “netlike” pattern that follows the vascular plexus.

31
Q

What is the cause of retiform purpura?

A

Vascular ischemia (usually due to an underlying thrombotic (blood clotting) disorder

*USUALLY DUE TO MENINGIOCOCCEMIA, congential coagulation defects, acquired coagulation defects

32
Q

What is widespread retiform purpura called?

A

purpura fulminans

33
Q

What can be a strange cause of retiform purpura?

A

adulterated cocaine (causes TONS of bland thrombi that lead to the cutaneous necrosis)

34
Q

If a patient has a fever with retiform purpura, what should you automatically expect?

A

meningococcemia (infection)

DERM (17 decks)

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