Skin purpura

Introduction Spontaneous mild skin imperfections or ecchymoses, mainly in the lower limbs, can occur in the upper limbs, but rarely occur in the trunk, no predisposing factors. Freckles or sputum are not the same size, uneven distribution, no higher than the surface, the pressure does not fade and does not hurt. There may be slight pain in the local area before the appearance of ecchymosis. Often, when the clothes are dressed in the morning of the next morning, the skin of the legs is consciously painful, and ecchymoses are found during the examination. Without treatment, the ecchymoses can resolve on their own, leaving a yellow-yellow pigmentation plaque that gradually disappears later. The purpura often recurs and is aggravated during the menstrual period. Patients generally have no internal organs and other parts of the bleeding. Mucosal bleeding is rare, sometimes a small amount of bleeding gums, increased menstrual flow, prolonged menstruation. The amount of bleeding during tooth extraction, surgery, trauma, and childbirth can be slightly more, but it will not cause severe bleeding.

Cause

(1) vascular system lesions: due to the disease of the blood vessel itself, such as damage to the blood vessel wall or increased permeability and brittleness of the blood vessel wall, causing leakage of red blood cells in the blood to form purpura. Vascular damage can be caused by bacterial toxins, chemical drugs, vitamin deficiency, and the like. Such as simple purpura, allergic purpura, increased intravascular pressure purpura and so on.

(2) Blood system lesions: bleeding due to an obstacle in the blood system. Such as thrombocytopenic purpura, hemophilia, fibrinogen-reducing purpura, prothrombin-reducing purpura caused by liver disease, and application of excessive anticoagulant drugs to purpura.

an examination

Related inspection

Bundle test platelet test item blood test

Laboratory inspection

(1) The beam arm test is positive or negative, but the routine examination of hemostasis function is normal.

(2) In a small number of patients, platelets are abnormal in ADP and adrenaline-induced aggregation, and the adhesion rate to the bead column is reduced.

Diagnostic criteria

(1) It is always healthy. Most of the lower extremities spontaneously appear sputum or ecchymosis, which can resolve on their own. No family history.

(2) The beam arm test is positive or negative, but the routine examination of hemostasis function is generally normal.

(3) It can exclude purpura caused by other causes.

Differential diagnosis

Differential diagnosis

Cyan red complexion: Cyanine may be caused by fish caused by histamine poisoning. Since animals such as shrimp, crab, and squid die, the protein in the body rapidly decomposes, producing a large amount of histamine. Eating these aquatic products will increase the histamine content in the human blood. If you eat improperly or allergic to the face or even the skin color, it will appear blue-red, discomfort, and sometimes accompanied by headache and itching.

Seasonal light red patches: "Peach Blossoms" Western medicine called "seasonal contact dermatitis." The disease occurs in women's face, initially flushed or reddish like a coin-like patch, a few with a small red pimples, the border is unclear, with a small amount of scales. Conscious itch or dry discomfort. Sometimes accompanied by allergic rhinitis or other "allergic" medical history. Because it tends to spring, it can heal itself after the season, so the Chinese medicine is called "Peach Blossom".

The skin of the hand is purple: the typical skin lesions of the purpura are scattered or scattered to the size of the needle to the size of the soybean, or erythema, maculopapular rash, blisters or wheal-like lesions, often symmetrically distributed on the extremities and hips of the extremities, with calves More common, consciously itching, there are no symptoms. Skin lesions gradually turn into brown spots in 1-1-2 weeks, and there are repeated episodes, some of which last for several years.

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