Understanding Purpura: Causes, Symptoms, Diagnosis, and Prevention of Purple Skin Spots

When blood vessels burst and leak under the skin, they can cause discoloured spots on the skin and mucous membranes. These discoloured spots are called purpura. Purpura is not a medical condition but a symptom. Various conditions can cause purpura. These include injury, infections, medications or other severe underlying conditions that impact blood clotting.

 

This article discusses the types, causes, risk factors, diagnosis and prevention of purpura.

 

What is Purpura?

 

Purpura is the name given to purple spots on the skin formed due to the bursting of small blood vessels under the skin’s surface. Several conditions that affect blood clotting can cause purpura.

 

Platelets in the blood, also known as thrombocytes, are responsible for forming blood clots. The types of purpura depend upon the blood platelet levels. These are:

 

1. Thrombocytopenic Purpura: A low platelet count is associated with this type of purpura. Low platelet count leads to difficulty forming blood clots.

2. Nonthrombocytopenic Purpura: In thrombocytopenic purpura, the blood platelet count is normal. Other conditions such as injury, ageing and blood clotting disorders cause this type of purpura.

3. Warfarin-induced Thrombocytopenia: This condition occurs due to the body’s adverse reaction to the drug warfarin and causes the blood to clot too much.

 

The last cause of purpura is rare. However, it requires immediate medical attention.

What Causes Purpura?

The causes of thrombocytopenic purpura spots include:

 

1. Immune Thrombocytopenic Purpura (ITP): Immune or idiopathic thrombocytopenic purpura is an autoimmune disorder where the immune system attacks and destroys the platelets in the blood. This leads to an elevated risk of bleeding and purpura.

2. Thrombotic Thrombocytopenic Purpura (TTP): TTP is a rare condition in which blood clots form all over the body and lower platelet count, causing purpura. It is serious and life-threatening.

3. Medications: Some medications, like blood thinners and chemotherapy drugs, can cause thrombocytopenic purpura.

4. Meningococcemia: It is a life-threatening bacterial infection that can cause purpura.

5. Autoimmune Conditions: Autoimmune conditions like lupus can cause purpura.

 

The nonthrombocytopenic purpura causes include:

 

1. Ageing that leads to thinning skin and fragile blood vessels
2. Viral infections such as due to the Epstein Barr virus
3. Blood vessel inflammation
4. Certain medications, such as corticosteroids
5. Blood clotting disorders
6. Vitamin C deficiency
7. Childbirth

What are Purpura Symptoms?

Thrombocytopenic purpura is caused by thrombocytopenia, which leads to a low blood platelet count. Immune thrombocytopenia purpura symptoms include:

 

1. Bleeding gums
2. Nose bleeds
3. Blood in stool or urine
4. Heavy menstrual bleeding
5. Prolonged bleeding, even in minor injuries

 

Symptoms of nonthrombocytopenic purpura depend upon the underlying cause and can include:

 

1. Itchiness around purple spots
2. Joint pain
3. Abdominal pain
4. Fever or flu-like symptoms
5. Diarrhea
6. Hives

What are the Risk Factors of Purpura?

The risk factors of purpura are as follows:

 

1. Ageing: The blood vessels become fragile in old age and are at a higher risk of purpura.
2. Sex: Females are at an elevated risk of purpura than males.
3. Family History: A family history of purpura puts one at a higher risk of developing the condition.
4. Health Conditions: Certain health conditions such as blood clotting disorders, viral infections, autoimmune conditions, obesity, and pregnancy can increase the risk of purpura.
5. Medication Use: Taking medicines that impact blood clotting, such as blood thinners and steroids, can raise the risk of developing purpura.

How is Purpura Diagnosed?

The doctor begins the purpura diagnosis with a physical exam. The physical exam includes closely examining the affected skin areas to confirm purpura. Once purpura is confirmed, the doctor can ask about the patient’s medical history.

 

Further diagnostic tests that can help diagnose the underlying cause of purpura are:

 

1. Complete Blood Count (CBC): CBC is a blood test that measures platelet levels, red blood cell, and white blood cell counts.
2. Skin Biopsy: In a skin biopsy, a small skin sample is closely examined under a microscope to confirm purpura.
3. Bone Marrow Exam: During a bone marrow biopsy, a small sample of bone marrow is obtained and examined for potential causes of low platelet count.

Purpura treatment depends upon the underlying condition.

How to Prevent Purpura?

Some types of nonthrombocytopenic purpura can be prevented by following the steps given here:

 

1. Protecting the skin by wearing full sleeves and applying sunscreen on the exposed areas.
2. Effectively managing the underlying health condition that causes purpura, such as autoimmune disorders.

 

Purple, discoloured patches on the skin are called purpura. Purpura is usually a symptom of an underlying health condition. Some causes of purpura can be severe and life-threatening. Routine health checkups can help identify the cause of purpura early, promising a better prognosis. Upon noticing symptoms of purpura given here, one must consult a doctor and get tested for Purpura at Dr. Lal PathLabs.

FAQs

1. Does purpura hurt?

Some people with purpura can have tender and sensitive skin.

2. What does purpura look like?

Purpura can look like a bruise or rash on the skin. Its colour depends on the skin tone.