Possible Causes for palpable purpura Vasculitis These spots can usually be felt by the examiner's fingertips, hence the descriptor "palpable". The image below is a classic example of palpable purpura. [web.archive.org] Abstract Cutaneous leukocytoclastic vasculitis (LCV) is type of small vessel vasculitis that commonly presents as palpable purpura involving the lower extremities and buttocks [ncbi.nlm.nih.gov] Abstract Leukocytoclastic vasculitis (LCV) is a disease characterized by inflammation of small vessels presenting with petechiae and palpable purpura. [ncbi.nlm.nih.gov] Leukocytoclastic Vasculitis Leukocytoclastic vasculitis (LCV), a disease characterized by inflammation of the small vessels, presents with palpable purpura, especially in the lower extremities. [ncbi.nlm.nih.gov] The patient was a 25-year-old man who had palpable purpura on his legs which showed leukocytoclastic vasculitis, and polyarteritis nodosa. [ncbi.nlm.nih.gov] Palpable purpura in lower limb was commonest presentation. Majority were idiopathic LCV. [nepjol.info] Henoch-Schönlein Purpura The criteria selected by a classification tree method were similar: palpable purpura, age less than or equal to 20 years at disease onset, biopsy showing granulocytes around [ncbi.nlm.nih.gov] The classic tetrad of signs and symptoms include palpable purpura, arthralgia, abdominal pain and renal disease. [ncbi.nlm.nih.gov] In contrast, patients who experienced relapses had a longer duration of the first episode of palpable purpura than those without relapses (palpable purpura lasting 7 days; [ncbi.nlm.nih.gov] Subacute Bacterial Endocarditis The case of a patient who had palpable purpura on his lower extremities due to Lactobacillus-caused subacute bacterial endocarditis is reported. [ncbi.nlm.nih.gov] Physical examination revealed palpable purpura, mild hypertension, hepatosplenomegaly, and a holosystolic cardiac murmur (Levine 2/6). [ncbi.nlm.nih.gov] Palpable purpura may also be seen. Imaging may reveal septic pulmonary infarcts, mycotic aneurysms, and stroke. [visualdx.com] Gram-Negative Septicaemia Med Hypotheses. 2014 Nov;83(5):563-5. doi: 10.1016/j.mehy.2014.08.024. Epub 2014 Sep 6. Author information 1 Department of Emergency Medicine, Waikato Hospital, Hamilton, New Zealand. Electronic address: martyn.harvey@waikatodhb.health.nz. 2 Department of Intensive Care, Tamworth Base Hospital, New South Wales, Australia.[…] [ncbi.nlm.nih.gov] Churg-Strauss Syndrome She became afebrile after 4 days, normotensive after 4 weeks, and her palpable purpura disappeared after 6 weeks. [mja.com.au] palpable purpura, livedo reticularis, urticaria, necrotic bullae and digital ischaemia. [patient.info] She had conjunctival pallor, gangrene involving all fingertips of the left hand, palpable purpura on the anterior aspect of the left leg, and 3/5 grade motor weakness of the [mja.com.au] Bacterial Endocarditis Palpable spleen Patients may have had non-specific symptoms (e.g. malaise, low-grade fever) for several weeks or even months, and may not have any of the specific signs. [almostadoctor.co.uk] Unknown murmurs Splenomegaly (40%) Coxiella infection – this particular bacterium will often caused a considerably enlarged liver and spleen Clubbing (10%) General fatigue Purpura [almostadoctor.co.uk] Acute Bacterial Endocarditis Palpable spleen Patients may have had non-specific symptoms (e.g. malaise, low-grade fever) for several weeks or even months, and may not have any of the specific signs. [almostadoctor.co.uk] Unknown murmurs Splenomegaly (40%) Coxiella infection – this particular bacterium will often caused a considerably enlarged liver and spleen Clubbing (10%) General fatigue Purpura [almostadoctor.co.uk] Infective Endocarditis Article View Abstract Journal of Cardiovascular Disease Research, 2017, 8, 2, 56-60. Published: June 2017 Type: Original Article Authors: Kundavaram Paul Prabhakar Abhilash, Shalom Patole, Mohan Jambugulam, Sowmya Sathyendra, Shubhanker Mitra, Grace Rebekah, Bijesh Yadav, Balaji Veeraraghavan, and Ooriapadickal C.[…] [jcdronline.org] Purpura Skin manifestations include palpable purpura, livedo reticularis, ulcers, and distal gangrene. [mdedge.com] purpura. [ijdvl.com] On physical examination, he still had palpable purpura of the legs. There was no swelling, but his joints were still tender to palpation. [mdedge.com] Rheumatoid Arteritis purpura. [thecurbsiders.com] […] difference in extremities, upper extremity claudication, aortitis, aortic aneurysm Medium vessels: supply gut abdominal pain, testes pain, infarct Small vessels: Skin causing palpable [thecurbsiders.com] Polyarteritis Nodosa Feels like there is an outbreak of vasculitis recently at the SFVA with a few morning reports on palpable purpura and it’s characteristic finding on pathology: leukocytoclastic [ucsfmed.wordpress.com] PANpable: Palpable purpura is seen in PAN. That's all! -IkaN [medicowesome.com] Livedo vascular pattern typical of cutaneous polyarteritis nodosa Expected results of diagnostic studies In the case of palpable purpura the cutaneous biopsy will show leukocytoclastic [dermatologyadvisor.com] Cryoimmunoglobulinemic Syndrome […] findings Biopsy ... 1/2011 MMI RPGN.ppt presentation ... • RF high • palpable purpura (leukocytoclastic vasculitis ) • Dx: biopsy • Bx: basement membrane ... [docpile.net] One or more skin lesions including palpable purpura, ulcers, digital gangrene, and areas of necrosis occur in 69-89% of these mixed disease cases (see attached photograph) [en.wikipedia.org] […] of the MC (Fig. 8, 9, 10 ); patients with mild-moderate symptoms, such as palpable purpura, are particularly sensitive to the smallest variations of daily steroid dosage [ojrd.biomedcentral.com] Hypocomplementemic Vasculitis There was scleral erythema, urticaria on the torso, palpable purpura on the legs, and swelling and tenderness of the hand joints. A diagnostic procedure was performed. [nejm.org] Physical exam Palpable purpura is pathognomonic for vasculitis. Palpable purpura consists of elevated, nonblanching erythematous lesions. [bobbybukamd.com] Palpable purpura and oral ulcers are common cutaneous manifestations of Wegener’s granulomatosis. [bobbybukamd.com] Idiopathic Cryoglobulinemia Cryoglobulin deposition causes a vasculitis that leads to petechiae and palpable purpura. [aafp.org] Cutaneous vasculitis with palpable purpura, especially in the lower extremities, should suggest cryoglobulinemia. [rheumaknowledgy.com] A physical examination revealed the presence of palpable purpura in the lower extremities; the rest of the exam was normal. [revistanefrologia.com] Systemic Vasculitis There is presence of skin vaculitis with palpable petechiae or purpura. [en.wikipedia.org] Drugs most commonly implicated are penicillin, sulphonamides and thiazide diuretics. [13] There is presence of skin vaculitis with palpable petechiae or purpura. [en.wikipedia.org] These spots can usually be felt by the examiner’s fingertips, hence the descriptor “palpable”. This is a classic example of palpable purpura. [hopkinsvasculitis.org] Pseudomonas Infection 2015 ICD-9-CM Diagnosis Code 041.7 Pseudomonas infection in conditions classified elsewhere and of unspecified site 2015 Billable Thru Sept 30/2015 Non-Billable On/After Oct 1/2015 ICD-9-CM 041.7 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 041.7 should only be used[…] [icd9data.com] Kawasaki Disease The dermatological manifestations include palpable purpura, ulcers or gangrenous-like pyoderma lesions. [scielo.br] Skin lesions occur in only 20 to 50% of the patients, and palpable purpura is the most common manifestations. [scielo.br] In Sjögren syndrome, cutaneous vasculitis may be manifested in 20% of the patients as palpable purpura ( Figure 6 ), ecchymosis and urticaria. [scielo.br] Staphylococcal Septicemia A previously healthy 5-year-old girl developed staphylococcal septicemia. Initially, cardiovascular failure with mitral insufficiency and purulent pericarditis dominated the clinical picture. Peripheral thromboembolic phenomena, meningitis, osteomyelitis, and persistent septicemia were subsequently encountered during[…] [ncbi.nlm.nih.gov] Septic Embolus J Korean Med Sci. 2013 Aug;28(8):1244-7. doi: 10.3346/jkms.2013.28.8.1244. Epub 2013 Jul 31. Author information 1 Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea. Abstract There has been a controversy over data of thrombolytic and endovascular surgical treatment about cerebral[…] [ncbi.nlm.nih.gov] Cutaneous Vasculitis We describe 4 patients who presented with palpable purpura, arthralgia or arthritis, leukopenia, and antineutrophil cytoplasmic antigen (ANCA) positivity most likely as a [ncbi.nlm.nih.gov] Palpable purpura was seen in 49.4% and frequently involved the lower limbs (50.6%). [ncbi.nlm.nih.gov] Lesions are often not specific, the most frequent being palpable purpura. [ncbi.nlm.nih.gov] Cryoglobulinemia Keys to Diagnosis: Palpable purpura in a dependent distribution is most suggestive of cryoglobulinemia. [rheumaknowledgy.com] Cutaneous lesions may include palpable purpura, urticaria-like lesions, livedo reticularis, Raynaud's phenomenon, acrocyanosis, gangrene and ulceration. [dermpedia.org] Cardinal Findings: Palpable purpura may be present on the lower extremities and rarely extends above the waist. [rheumaknowledgy.com] Microscopic Polyangiitis Skin findings are as follows: Leukocytoclastic angiitis and its palpable purpura - Leukocytoclastic purpura could be a manifestation of the systemic vasculitides or could [emedicine.medscape.com] purpura, abdominal pain, myalgias, arthralgias, mild hypertension Birmingham Vasculitis Activity Score (BVAS, online calculator): useful for determining disease activity [pathologyoutlines.com] purpura, abdominal pain, myalgias, arthralgias, mild hypertension Birmingham Vasculitis Activity Score (BVAS, online calculator ): useful for determining disease activity [pathologyoutlines.com] Cryoglobulinemic Vasculitis A 53-year-old woman presented with recurrent episodes of palpable purpura affecting the lower legs. [jaad.org] Physical exam revealed palpable purpura on the dorsum of both feet. [mushare.marian.edu] When symptoms occur, they may include: Weakness Joint pain or swelling (arthralgia or arthritis) A raised, purple skin rash (palpable purpura) usually in the lower portion [webmd.com] Rocky Mountain Spotted Fever Vasculitis is marked by palpable purpura rather than petechiae. Drug eruptions will have a history of exposure. [visualdx.com] On admission, she had petechiae in some areas and blanching erythematous papules in others, but no palpable purpura. [dx.doi.org] Hyperglobulinemic Purpura Wallach Date: Oct, 1995 Palpable purpura is a cutaneous manifestation of several diseases. [drplace.com] Causes of Palpable purpura Note: Image search may contain inaccuracies Churg-Strauss syndrome Cryoglobulinaemia Erythema multiforme Henoch-Schoenlein purpura Leukocytoclastic [xdiagnosis.net] Palpable purpura and livedo reticularis can occur in some patients. There is presence of skin vaculitis with palpable petechiae or purpura. [diki.pl] Acute Gastroenteritis Here we document a rare case of anaphylactoid purpura which manifested with skin lesions in the form of palpable purpura following about of acute gastroenteritis with severe [ncbi.nlm.nih.gov] Rickettsia Infection Ticks Tick Borne Dis. 2016 Jul;7(5):653-656. doi: 10.1016/j.ttbdis.2016.02.010. Epub 2016 Feb 8. Khrouf F 1, Sellami H 2, Elleuch E 3, Hattab Z 4, Ammari L 5, Khalfaoui M 6, Souissi J 4, Harrabi H 5, M'ghirbi Y 1, Tiouiri H 5, Ben Jemaa M 3, Hammami A 2, Letaief A 4, Bouattour A 7, Znazen A 2. Author information 1 Laboratory[…] [ncbi.nlm.nih.gov] Necrotizing Vasculitis Cutaneous necrotizing vasculitis is a heterogeneous group of disorders characterized clinically by palpable purpura, and histologically by a segmental angiocentric inflammatory [ncbi.nlm.nih.gov] purpura. [ncbi.nlm.nih.gov] Palpable purpura. If patients have this in isolation, it is most likely due to cutaneous leukocytoclastic vasculitis. [en.wikipedia.org] Urticarial Vasculitis Abstract A middle aged female patient presented with generalised palpable purpura associated with intense pruritus along with subconjunctival haemorrhage and orbital inflammation [ncbi.nlm.nih.gov] Besides urticarial lesions, other features such as palpable purpura (n 7), arthralgia and/or arthritis (n 13), abdominal pain (n 2), nephropathy (n 2), and peripheral neuropathy [ncbi.nlm.nih.gov] The cutaneous features may include painful, burning or pruritic skin lesions, the persistence of individual lesions greater than 24 hours, palpable purpura, pronounced central [ncbi.nlm.nih.gov]
