What is in the Differential Diagnosis of Purpura?

Discussion Children presenting with rashes are common but certain characteristics may be concerning such as descriptions of petechiae or purpura. Purpura are characterized by non-blanching skin lesions between 3-10 mm in size that are caused by bleeding into the skin. Usually they are reddish-purplish hence the name purpura coming from the Latin word. Non-blanching lesions that are 10 mm are ecchymosis. Henoch-Schönlein purpura (HSP) is a generalized vasculitis that commonly involves the gastrointestinal tract, kidneys, skin and joints, and is especially seen in children 2-11 years old. Classically HSP presents with purpura of the lower-extremities (or other dependent areas), migratory polyarthritis, colicky abdominal pain, and renal disease. A macular-papular or urticarial rash can precede the purpura, but generally resolves within 24 hours such as the one above. Peripheral edema can occur because of the renal involvement. Its etiology is uncertain but is probably multifactorial with antigens, environmental and genetic factors. It is thought to be caused by an unknown antigen stimulating a rise in IgA producing and antigen-antibody complexes being deposited locally in the body and activating pathways leading to necrotizing vasculitis. Associations with bacteria, viruses, vaccinations and drugs have been reported. Most children have complete recovery but serious renal and gastrointestinal complications may occur. Learning Point The differential diagnosis of purpura inc...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news