Petechiia, Purpura, and Vasculitis Flashcards
What is a hallmark sin for leukocytoclastic vasculitis?
palpable purpura
What is purpura?
non-blanchable, pink to purple macules/patches or papules caused by extravasated RBCs in skin or mucous membranes
What is Diascopy?
use of a glass slide to apply pressure to lesion in order to distinguish erythema secondary to vasodilation (will blanch) from erythrocyte extravasation.
What are the main causes of purpura?
- Coagulation/clotting abnormalities
- Leaky or abnormal blood vessels
- Trauma/other causes
What are the two types of purpura?
- Non-palpable purpura (generally non-inflammatory)
- Palpable purpura (sign of vascular inflammation)
Waht are the features of petechiae?
- Small <3mm red or purple dots seen on dependent areas of the body
- Painless
- Non-palpable
- Non-inflammatory
Who is more likely to have petechiae, hemophiciac or patient receiving chemo?
Patient receiving chemo (due to thrombocytopenia)
What are the two broad classes of petechiae causes?
- Platelet related (low platelets or platelet dysfunction)
- Non-platelet releated (increase of capillary fragility or things that allow them to leak)
Patients with scurvy lack what vitamin?
Vitamin C (need this to make collagen–to protect tiny capillaries of the skin)
What are features of ecchymosis?
- Larger areas of purpura (>5mm)
- Can be on any area of the body
- May/may not be painful/tender
What is the major cause of ecchymosis?
abnormality in coagulation (hyper OR hypocoagulable)
What are some causes of purpura related to anticoagulant + trauma?
- DIC
- Renal/hepatic dysfunction
- Anticoagulant medications
- Vitamin K deficiency
What are some causes of purpura related to poor dermal support?
- Actinic damage
- Amyloid
- Steroid-induced atrophy
- Trauma
- Scurvy
- Ehlers Danlos
What is linear purpura most likely due to?
blood pressure cuffs used on thrombocytopenic patients
What is Waldenstrom hypergammaglobulinemic purpura?
looks like little red marks on skin?
What is Henoch-Schonlein purpura?
most common form of systemic vasculitis in children (3-15) that follows preceding viral or bacterial infection that causes inflammation of superficial blood vessels
How do you diagnose Henoch-Schonlein purpura?
punch biopsy (immune complexes in vessel walls contain IgA deposition)
What are symptoms of Henoch-Schonlein purpura?
palpable purpura (that can blister), arthritis, abdominal pain, kidney disease
Do adults get Henoch-Schonlein purpura?
Yes–they are at HIGHER risk of kidney involvement!
Is vasculitis localized to the skin?
NO- can affect kidneys, lungs, CNS, and GI tract
What ist he primary determinant in classification of vasculitis?
size of blood vessel
List diseases with small vessel vasculitis.
- Henoch Schonlein purpura
- Infections (ex. meningococcemia)
- Drug reactions
- Autoimmune disease (ex. SLE)
- Malignancy-associated vasculitis (ex. myelodysplasia)
- Idiopathic/hypersensitivity vasculitis
List diseases with “mixed” sized vasculities.
ANCA-associated:
- Churg-Strauss
- Microscopic polyangitis
- Wegener’s granulomatosis
Cryoglobulinemia
What is the medium vessel vasculitis?
polyarteritis nodosa
