Purpura
Look For
- Red / purple lesions that do not blanch with pressure. May be present over the head, arms, legs, chest or abdomen.
Causes of Purpura
Trauma
Platelet Disorders
- Idiopathic thrombocytopaenic purpura (ITP)
- Thrombotic thrombocytopaenic purpura (TTP)
- Disseminated intravascular coagulation (DIC)
- Bone marrow failure - aplastic anaemia, leukaemia, chemotherapy
- Platelet sequestration - splenomegaly, haemangioma
- Haemolytic-uraemic syndrome
- Inherited disorders of platelet function
Disorders of Coagulation
- Factor deficiencies - haemophilia, Von Willebrand disease
- Vitamin K deficiency - malabsorption, poor diet
- Anticoagulants
- Disseminated intravascular coagulation (DIC)
Vascular Disorders
- Connective tissue diseases - Ehlers-Danlos, scurvy
- Infection - mengingococcal, streptococcal, viral
- Henoch-Schönlein purpura
- Senile purpura
- Steroids
Scratch Marks
Look For
- Scratch marks over the skin of the face, arms, chest or abdomen.
Significance
- An indicator that the patient has been pruritic.
Causes of Pruritis
- Obstructive jaundice (bile acid deposition)
- Chronic kidney disease (urea deposition)
- Skin conditions - dry skin, atopic eczema, psoriasis, lichen planus, ichthyosis
- Infection - herpes zoster, scabies, fungal infections
- Myeloproliferative disorders
- Hyperthyroidism
- Pregnancy
- Neuropathic itch
- Psychogenic itch
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