Purpura simplex is a common, benign vascular purpura characterized by easy bruising. It typically affects healthy young women in absence of trauma or history of abnormal bleeding. The key component of the workup is the patient's history, which is negative in these patients. Coagulation studies are also normal.
Purpura simplex/easy bruising is a very common condition in the vascular purpura family . This idiopathic skin manifestation occurs in healthy individuals and predominantly affects young women  . Purpura refers to the deposition of red blood cells beneath the skin  although the mechanism of this type is unclear. There may be a hereditary component  or relation to medication use such as nonsteroidal anti-inflammatory drugs (NSAIDs)  . Additionally, episodes of purpura simplex may manifest during the patient's menstrual period  .
The typical presentation of these patients is spontaneous bruising on thighs, upper arms, and/or buttocks accompanied by an otherwise unremarkable physical exam. A review of history reveals no trauma or preceding event. Very importantly, patients do not have a history of bleeding disorders, menorrhagia, or exaggerated bleeding with vaginal deliveries or surgery .
Generally, purpura describes unblanched reddish or purplish pigmented lesions, which measure at 3 to 10mm . According to one study, the appearance of purpura simplex may be characterized as macular purpura and petechia .
The insignificant history of these patients is indicative of the benign nature of purpura simplex. Therefore, the prognosis of these patients is excellent and patients should be reassured . Moreover, the majority of patients will have a resolution of the purpura .
When evaluating bruising, which is common in primary care, the patient's history is an essential component in the diagnostic process. The clinician should investigate the patient's medical and family history with regards to bleeding and bruising disorders and whether there is a personal history of bleeding that is out of proportion to trauma such as childbirth and surgery  . Furthermore, other significant factors for consideration are age and gender . Other key questions should explore frequent causes of bruising such as physical abuse or trauma, use of medications such as anticoagulants, antiplatelet drugs, and NSAIDs, nutritional deficiencies, alcohol use, underlying diseases such as liver cirrhosis, or recent illness  .
Since the above inquiries for those with purpura simplex are unremarkable, the bleeding score system yields a negative score for these patients .
If laboratory tests are performed, all initial bleeding studies including a complete blood count (CBC), prothrombin time (PT), partial thromboplastin time (PTT), and platelet function assay (PFA-100) are normal in patients with purpura simplex  . Also, a peripheral blood smear can reveal the abnormalities of platelets . Generally, these parameters evaluate different pathways of the clotting cascade. For example, the PT assesses the extrinsic and common pathways while PTT evaluates the intrinsic and common pathways .