Purpura are red or purple spots on the skin that are caused by the accumulation of blood below the skin. They usually do not disappear when pressed, and can occur at any age.
Purpura are usually related to blood vessel inflammation, but can appear for many reasons. Depending on the underlying cause, treatment may or may not ne necessary. In children, purpura disappear without any specific treatment, although in adults, they can turn into a chronic problem that appear and disappear.
Purpura spots can vary in size. They are referred to as petechiae when they are 1 to 2 mm in diameter, and as ecchymosis when they are over 1 cm in diameter. If you notice red or purple spots on your skin, you should see your doctor for assessment and treatment as needed.
Types of purpura
There are many types of purpura that vary depending on their cause. The main types include:
1. Henöch-Schönlein purpura
Henöch-Schönlein purpura (also known as HSP or IgA vasculitis) is more frequent in children, although it can be seen in adults.
What it looks like: This type of purpura is characterized by inflammation of small blood vessels, leading to red spots, particularly in the legs and glutes. It can lead to joint and abdominal pain.
How to treat: Normally, HSP does not require any treatment. Patients are advised to rest and continue being monitored by a doctor to evaluate for any worsening of symptoms. However, patients who experience a lot of pain may be prescribed anti-inflammatories or analgesics, like ibuprofen and acetaminophen, to relieve pain.
2. Idiopathic thrombocytopenic purpura
Idiopathic thrombocytopenic purpura (or ITP) is an autoimmune disease characterized by a decrease in platelet count, leading to clotting issues.
What it looks like: Due to abnormalities in coagulation, it is possible to also notice small red points on the skin as well as plenty of nose bleeds. Diagnosis is confirmed through blood tests, while positive cases will usually show a platelet count of less than 10.000 platelets/mm³ in the blood.
How to treat: Treatment for ITP is done according to the severity of symptoms. A doctor may prescribe medications to decrease immune system function to decrease immune responses and attacks on the body. Another treatment method includes immunoglobulin injections and medications to stimulate platelet production in the bone marrow.
3. Thrombotic thrombocytopenic purpura
Thrombotic thrombocytopenic purpura (TTP) is a rare type of purpura that can be life-threatening. This type of purpura is characterized by increase platelet aggregation, leading to the formation of clots and destruction of blood cells. It is important for TTP to be treated as quickly as possible to prevent anemia, platelet loss and neurologic changes.
How to treat: Treatment for TTP should be initiated promptly, and usually involves a plasmaphoresis. This involves filtering the blood of excessive antibodies that may be interfering with normal body functioning.
4. Purpura fulminans
Purpura fulminans emerges mainly in newborns due to a lack of proteins related to coagulation. It leads to the formation of clots that interfere with proper blood circulation. This type of purpura can occur as a result of a serious blood infection, mainly meningococcus.
What it looks like: Due to changes in the clotting process, small red spots on the skin appear. These can turn barker due to cell death in the area.
How to treat: Treatment for purpura fulminans involves the administration of the clotting protein that is missing, as directed by a doctor.
5. Senile purpura
This type of purpura occurs due to naturally aging and the weakening of the blood vessels. It is more common in people over 65 years of age.
What it looks like: It is possible to note the appearance of purple spots on the back, wrists, hands and forearms.
How to treat: Senile purpura does not require treatment, as they do not pose any risks for health or for increased bleeding. However, patients who are uncomfortable with these spots can apply creams or ointments with vitamin K, which help to reduce the appearance of the spots.