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Purpura Simplex

Simple Bruising

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.


Presentation

Purpura simplex/easy bruising is a very common condition in the vascular purpura family [1]. This idiopathic skin manifestation occurs in healthy individuals and predominantly affects young women [2] [3]. Purpura refers to the deposition of red blood cells beneath the skin [1] although the mechanism of this type is unclear. There may be a hereditary component [4] or relation to medication use such as nonsteroidal anti-inflammatory drugs (NSAIDs) [5] [6]. Additionally, episodes of purpura simplex may manifest during the patient's menstrual period [1] [5].

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 [7].

Generally, purpura describes unblanched reddish or purplish pigmented lesions, which measure at 3 to 10mm [8]. According to one study, the appearance of purpura simplex may be characterized as macular purpura and petechia [6].

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 [7]. Moreover, the majority of patients will have a resolution of the purpura [6].

Easy Bruising
  • 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.[symptoma.com]
  • From Jump to: navigation , search Contents 1 Epidemiology 2 Clinical-manifestations 3 Laboratory 4 More General Terms 5 References Epidemiology children & middle-aged women most frequently affected Clinical-manifestations easy bruising legs frequently[anvita.info]
  • The history usually reveals no other abnormal bleeding, but easy bruising may be present in family members. Serious bleeding does not occur. The platelet count and tests of platelet function, blood coagulation, and fibrinolysis are normal.[merckmanuals.com]
  • A 78 year old woman presents with a three month history of easy bruising. She also feels tired and has lost her appetite.[bmj.com]
Painter
  • Seite 210 - Painter's colic (Op.) ; pain in umbilical region, extending through to the back ; patient screams and tries to relieve the pain by turning in all possible positions ; pressing and bearing down in the abdomen, extending into the pelvis; constipation[books.google.com]
Purpura
  • 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.[symptoma.com]
  • purpura hemorrhagica purpura hemorrhagica purpura hemorrhagica purpura hemorrhagica purpura nervosa purpura nervosa purpura nervosa purpura nervosa purpura pigmentosa progressiva purpura pulicans purpura pulicosa purpura rheumatica purpura rheumatica[medical-dictionary.thefreedictionary.com]
  • Ebhg 30 Purpura simplex Resultater: 30 Purpura Simplex - Blood Disorders - Merck Manuals Consumer Purpura simplex is increased bruising that is due to fragile blood vessels. Purpura simplex is extremely common. The cause is not known.[recipereminiscing.xyz]
  • Treatment - Purpura simplex Not supplied. Resources - Purpura simplex Not supplied.[checkorphan.org]
  • K.V. 1993 3 Purpura simplex (inflammatory purpura without vasculitis): a clinicopathologic study of 174 cases. ( 1791222 ) Ratnam K.V....Peters M.S. 1991 4 Familial hereditary purpura simplex with SchAPnlein-Henoch syndrome; response to corticotropin[malacards.org]
Chorea
  • Seite 193 - True cerebral chorea, with clonic spasms when awake, quiet when asleep, though jerking when going to sleep; spasmodic motions, from simple involuntary motions and jerks of single muscles to a dancing of the whole body... ‎[books.google.com]

Workup

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 [7] [9]. Furthermore, other significant factors for consideration are age and gender [9]. 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 [9] [10].

Since the above inquiries for those with purpura simplex are unremarkable, the bleeding score system yields a negative score for these patients [7].

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 [7] [9]. Also, a peripheral blood smear can reveal the abnormalities of platelets [9]. 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 [7].

Toxocara Canis
  • Henoch-Schonlein purpura (HSP) is a form of systemic leukocytoclastic vasculitis (LCV) .... simplex virus, Helicobacter pylori, Toxocara canis, hu- man parvovirus B19, and coxsackie virus as well as.[recipereminiscing.xyz]

Treatment

Prognosis

  • 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.[symptoma.com]
  • Diagnosis - Purpura simplex The list of diagnostic tests mentioned in various sources as used in the diagnosis of Purpura simplex includes: * Platelet tests * Blood clotting tests Prognosis - Purpura simplex Not supplied.[checkorphan.org]
  • Purpura Simplex (Simple Bruising) SYMPTOMA.com Purpura Simplex (Simple Bruising): Symptoms Workup Diagnosis Treatment Complications Causes Epidemiology Incidence Prognosis Check at SYMPTOMA.com Purpura simplex is a common, benign vascular purpura characterized[recipereminiscing.xyz]
  • Prognosis Many lesions persist or extend with time. Most eventually resolve spontaneously.[emedicine.medscape.com]
  • Prognosis: —The prognosis is unfavorable in most cases and should always be guarded. The danger depends upon the extent of the hemorrhages and the amount of blood lost.[henriettes-herb.com]

Etiology

  • Pathophysiology The etiology is unknown.[emedicine.medscape.com]
  • PLATELET DYSFUNCTION Congenital Etiologies.[aafp.org]
  • […] that have different clinical morphologies but similar histopathologic examinations. 2 All PPDs are characterized by nonblanching, nonpalpable, purpuric lesions that often are bilaterally symmetrical and present on the legs . 2,3 Although the precise etiology[mdedge.com]
  • In etiology of the PPD, viral and bacterial agents have been accused. [10] , [11] Satoh et al reported five patients with PPD having odontogenic infection that their illness regressed by the treatment of the infection. [10] Erbagcý et al . reported two[e-ijd.org]

Epidemiology

  • From Jump to: navigation , search Contents 1 Epidemiology 2 Clinical-manifestations 3 Laboratory 4 More General Terms 5 References Epidemiology children & middle-aged women most frequently affected Clinical-manifestations easy bruising legs frequently[anvita.info]
  • Purpura Simplex (Simple Bruising) SYMPTOMA.com Purpura Simplex (Simple Bruising): Symptoms Workup Diagnosis Treatment Complications Causes Epidemiology Incidence Prognosis Check at SYMPTOMA.com Purpura simplex is a common, benign vascular purpura characterized[recipereminiscing.xyz]
  • Extravasation of red blood cells with marked hemosiderin deposition in macrophages is also found, and a rare granulomatous variant of chronic pigmented dermatosis has been reported. [3] Epidemiology Frequency United States Pigmented purpuric dermatoses[emedicine.medscape.com]
  • Epidemiology The incidence is rising as there is greater recognition of the condition. It is currently around 3.7 cases per million patients. TTP is rare, with a reported incidence of 6 per 1,000,000 per year in the UK.[patient.info]
  • "Epidemiology of immune thrombocytopenic purpura in the General Practice Research Database". Br. J. Haematol . 145 (2): 235–44. doi : 10.1111/j.1365-2141.2009.07615.x . PMID 19245432 . a b Roback et al. AABB Technical Manual, 16th Ed.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • By concisely combining cutting-edge explanations of disease pathophysiology with practical approaches to the diagnosis and management of hematologic disorders, it provides an invaluable vade mecum for today's physicians and students needing to keep up[books.google.com]
  • Pathophysiology The etiology is unknown.[emedicine.medscape.com]

Prevention

  • Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets[books.google.com]
  • No drug prevents the bruising; patients are often advised to avoid aspirin and aspirin -containing drugs, but there is no evidence that bruising is related to or worsened by their use. Patients should be reassured that the condition is not serious.[merckmanuals.com]
  • ., Cushing\'s and diabetes have associated nonpalpable purpura) Prevention - Purpura simplex Not supplied.[checkorphan.org]

References

Article

  1. Modi AV. Spontaneous Bruising in a Family Practice Population: How common and how benign is it? Can Fam Physician. 1992;38:1805-8.
  2. Ramanan SV. A very rare bleeding disorder. BMJ : British Medical Journal. 1998;317(7170):1437.
  3. Goroll AH, Mulley AG. Primary care medicine: Office evaluation and management of the adult patient. Philadelphia, PA: Lippincott Williams & Wilkins; 2006: 1247.
  4. Davis E. Hereditary familial purpura simplex. Lancet. 1941; 237(6127):145-146.
  5. Goroll AH, Mulley AG. Primary care medicine: Office evaluation and management of the adult patient. Philadelphia, PA: Lippincott Williams & Wilkins; 2006: 645.
  6. Ratnam KV, Su WP, Peters MS. Purpura simplex (inflammatory purpura without vasculitis): a clinicopathologic study of 174 cases. J Am Acad Dermatol. 1991;25(4):642-647.
  7. Ballas M, Kraut EH. Bleeding and bruising: a diagnostic work-up. Am Fam Physician. 2008;77(8):1117-24.
  8. Mitchell RS, Kumar V, Robbins SL, Abbas AK, Fausto N, eds. Robbins basic pathology. 8th ed. Philadelphia, PA: Saunders Elsevier; 2007: 10–11.
  9. Harrison LB, Nash MJ, Fitzmaurice D, Thachil J. Investigating easy bruising in an adult. BMJ. 2017;356:j251.
  10. Neutze D, Roque J. Clinical Evaluation of Bleeding and Bruising in Primary Care. Am Fam Physician. 2016;93(4):279-86.

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Last updated: 2018-06-22 09:32