Have you ever noticed a purple spot or a bunch of small spots suddenly appearing on your skin, especially on your arms or legs, without you even touching it? Sometimes these look like bruises, but they can actually be something else. In medicine, we call this condition purpura. Don't worry, this is not a disease, but it can be a symptom of another underlying condition. So today, let's talk about everything in simple terms.
What exactly is Purpura?
Simply put, purpura is a condition where tiny blood vessels under our skin leak blood, causing spots on the skin's surface. These can occur on your skin or on the mucous membranes like your mouth and throat.
The appearance of these spots varies depending on your skin tone.
- For someone with fair skin: These appear as a reddish-purple color.
- For someone with a lighter skin tone: These may be brown or black in color.
The important thing is that purpura is not a disease, but a symptom of another condition. This condition can be caused by certain medications, vitamin deficiencies, or even some congenital conditions. Therefore, if such spots appear for no apparent reason, it is best to inform a doctor about it.
Is there a difference between these types of spots?
Yes, these spots caused by bleeding under the skin are called by three names depending on their size. It is very important for you to know this.
| Name of the spot | Size | Simple description |
|---|---|---|
| Petechiae | Less than 4 mm | These are, to be precise, very small spots, like a dot made by a pen tip. Often, these are clustered together, so some people mistake them for a rash. |
| Purpura | Between 4 and 10 millimeters (less than 1 centimeter) | This is the main type of mole we're talking about. These are a little larger than petechiae. |
| Ecchymoses | More than 1 centimeter | These are what we usually call "thale roadways ." These are large in size. |
What's special about these spots is that if you press on them with your finger, they don't change color (non-blanching). A normal rash turns pale when pressed and turns red again when touched.
What are the main causes of purpura?
The cause of purpura depends on its type. It is mainly divided into two types. One is based on the number of platelets in our blood. Platelets are small cells that help stop bleeding and form blood clots when we bleed.
1. Thrombocytopenic Purpura: This is when the number of platelets in the blood decreases.
2. Non-thrombocytopenic Purpura: Here, although the platelet count is normal, blood leaks from the blood vessels for another reason.
Let us see clearly what these reasons are in the table below.
| Causes of Purpura | |
|---|---|
| 1. Due to low platelet levels (Thrombocytopenic Purpura) | |
| |
| 2. Causes of normal platelet levels (Non-thrombocytopenic Purpura) | |
|
Important: Purpura can also occur as a severe reaction to blood-thinning medications such as heparin and warfarin, or in very serious, but rare, conditions such as DIC (Disseminated Intravascular Coagulation). These are situations that require emergency medical treatment.
How does a doctor diagnose this condition?
When you go to see a doctor with a mole like this, the first thing he or she will do is examine your skin carefully. Then, they will ask about your complete medical history and the medications you are taking.
To find out the exact cause of purpura, your doctor may order some tests.
- Complete Blood Count (CBC): This mainly checks the number of platelets in your blood. Knowing whether your platelets are low or not can help determine the cause.
- Skin Biopsy: Sometimes, if the platelet count is normal, a very small piece of skin may be taken and tested to see if there is a condition called vasculitis.
These tests are used to identify the exact underlying condition causing the purpura.
How is it treated?
Remember, the treatment is not for the purpura spots, but for the underlying condition that caused them. Sometimes, especially in children, these spots go away without any treatment.
Once the cause is identified, the doctor may do the following:
- If you are taking a medication that causes purpura, change or stop it.
- Treatment of an underlying medical condition (e.g., an infection, an immune disease).
- If the platelet count is too low, provide treatment to increase it.
Some treatments used to increase platelet count are:
- Corticosteroids: Drugs that stop platelet destruction.
- IVIG treatment (Intravenous Immunoglobulin): This treatment, given through a vein, quickly increases platelet levels.
- Immunosuppressants: For example, drugs such as Rituximab.
- Blood Transfusion: Providing platelets to the body from outside, if necessary.
- Splenectomy: In some cases, the spleen, which is a major contributor to platelet destruction, is surgically removed.
If you notice these kinds of spots, blemishes, or bruises on your skin for no apparent reason, don't ignore them. Definitely see your doctor. Because sometimes this is nothing serious, but at other times it can be the first sign of a life-threatening disease. Therefore, the right thing to do is to seek medical advice.
Take-Home Message
- Purpura is a purple, red, or brown spot caused by blood leaking from the tiny blood vessels under the skin.
- This is not a disease, but a symptom of another underlying condition.
- These are classified by size as petechiae (smallest), purpura (medium), and ecchymosis (bruises/largest).
- Causes include low platelet count, medications, infections, and blood vessel weakness.
- If you notice these types of spots without any bruising, don't ignore them. Definitely seek medical advice.
- The treatment does not address the spots, but the underlying condition that caused them.
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