Table of ContentsView AllTable of ContentsAppearanceCausesDiagnosisTreatmentWhen to Call a Provider
Table of ContentsView All
View All
Table of Contents
Appearance
Causes
Diagnosis
Treatment
When to Call a Provider
Petechiaeandpurpuraare two related symptoms that occur when tiny blood vessels calledcapillariesburst and leak under the skin. Petechiae are tiny, red pin spots that often develop in clusters, while purpura is a larger area of discoloration that tends to be more purplish.
This article describes the symptoms and causes of petechiae and purpura, including how they are diagnosed and treated.
This photo contains content that some people may find graphic or disturbing.See PhotoPurpura.Reproduced with permission from ©DermNet New Zealand and © Raimo Suhonenwww.dermnetnz.org2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from ©DermNet New Zealand and © Raimo Suhonenwww.dermnetnz.org2023.
Petechiae vs. Purpura: Difference in Appearance
Where they differ is in their size, shape, texture, and color. By definition:
Areas that are larger than 10 mm are referred to asecchymosis, also known as bruising.
Petechiae usually appear as a cluster of tiny “bloodspots” that sit flat against the skin. With purpura, one or many areas of discoloration may be irregular in shape and often raised.
Because petechiae are smaller, they tend to be seen as bright red spots that vanish relatively quickly. Purpura may initially be red but quickly turn purple for a longer period due to the larger volume of blood that needs to be broken down and absorbed.
How Long Does Petechia and Purpura Last?Petechiae typically resolves in two to three days, although it can evolve into purpura if underlying bleeding doesn’t stop. Depending on its size, purpura can often resolve within a week but can sometimes take a month or more.
How Long Does Petechia and Purpura Last?
Petechiae typically resolves in two to three days, although it can evolve into purpura if underlying bleeding doesn’t stop. Depending on its size, purpura can often resolve within a week but can sometimes take a month or more.
This photo contains content that some people may find graphic or disturbing.See PhotoPetichae.Reproduced with permission from ©DermNet New Zealand and © Dr Lawrence Meyersonwww.dermnetnz.org2023.
Reproduced with permission from ©DermNet New Zealand and © Dr Lawrence Meyersonwww.dermnetnz.org2023.
Causes of Petechiae and Purpura
There are three main causes of petechiae and purpura, categorized as:
Thrombocytic Causes
Thrombocytes (also called platelets) are a type of blood cell that clump together whenever there is bleeding. The clot they form can help stop bleeding.
Thrombocytopeniais a potentially serious condition where platelet numbers are very low, often due to infections or diseases that destroy them.
Causes of thrombocytopenia include:
Vascular Causes
Vascular causes of purpura or petechiae are those in which blood vessels are structurally damaged or compromised, causing bleeding.
Causes include:
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Coagulopathy
Coagulopathy refers to bleeding problems that interfere with clotting rather than those that cause the loss or destruction of platelets.
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How Petechiae and Purpura Are Diagnosed
Purpura and petechiae are diagnosed with a physical exam.Both symptoms are relatively easy to recognize but may be mistaken for other conditions, such asstasis dermatitis(a type of eczema) and skin cancers likebasal cell carcinoma.
One way to help confirm the diagnosis is to press a water glass against the lesions. If they do not blanch (turn white), it is a positive sign of petechiae or purpura.
Both also tend to develop suddenly rather than gradually. With petechiae, there will typically be multiple spots rather than a single one.
If there is any doubt as to the cause, the healthcare provider may take atissue biopsy, This involves a device similar to a hole punch that can extract a small column of tissue for evaluation in the lab.
To narrow the possible causes of purpura or petechiae, the healthcare provider will review your medical history, family history, medication use, and other symptoms you may have.
Treatment of Petechiae and Purpura
When to Call a Healthcare Provider
Petechiae or purpura may be due to simple injury, medications you are taking, or aging-related skin damage. In cases like these, there is no cause for alarm, but it may be in your interest to see your healthcare provider if the symptom is severe or persistent.
Summary
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Royal Children’s Hospital Melbourne.Clinical practice guidelines - petechiae and purpura.MedlinePlus.Purpura.Reyes MA, Eichenfield LF.Petechiae and macular purpura. In:Principles and Practice of Pediatric Infectious Diseases (Fifth Edition).New York NY: Elsevier; 2018.National Heart, Lung, and Blood Institute.Thrombocytopenia.MedlinePlus.Bleeding into the skin.Zarka F, Veillette C ,Makhzoum JP.A review of primary vasculitis mimickers based on the Chapel Hill Consensus Classification.Int J Rheumatol.2020;2020:8392542. doi:10.1155/2020/8392542
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Royal Children’s Hospital Melbourne.Clinical practice guidelines - petechiae and purpura.MedlinePlus.Purpura.Reyes MA, Eichenfield LF.Petechiae and macular purpura. In:Principles and Practice of Pediatric Infectious Diseases (Fifth Edition).New York NY: Elsevier; 2018.National Heart, Lung, and Blood Institute.Thrombocytopenia.MedlinePlus.Bleeding into the skin.Zarka F, Veillette C ,Makhzoum JP.A review of primary vasculitis mimickers based on the Chapel Hill Consensus Classification.Int J Rheumatol.2020;2020:8392542. doi:10.1155/2020/8392542
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Royal Children’s Hospital Melbourne.Clinical practice guidelines - petechiae and purpura.MedlinePlus.Purpura.Reyes MA, Eichenfield LF.Petechiae and macular purpura. In:Principles and Practice of Pediatric Infectious Diseases (Fifth Edition).New York NY: Elsevier; 2018.National Heart, Lung, and Blood Institute.Thrombocytopenia.MedlinePlus.Bleeding into the skin.Zarka F, Veillette C ,Makhzoum JP.A review of primary vasculitis mimickers based on the Chapel Hill Consensus Classification.Int J Rheumatol.2020;2020:8392542. doi:10.1155/2020/8392542
Royal Children’s Hospital Melbourne.Clinical practice guidelines - petechiae and purpura.
MedlinePlus.Purpura.
Reyes MA, Eichenfield LF.Petechiae and macular purpura. In:Principles and Practice of Pediatric Infectious Diseases (Fifth Edition).New York NY: Elsevier; 2018.
National Heart, Lung, and Blood Institute.Thrombocytopenia.
MedlinePlus.Bleeding into the skin.
Zarka F, Veillette C ,Makhzoum JP.A review of primary vasculitis mimickers based on the Chapel Hill Consensus Classification.Int J Rheumatol.2020;2020:8392542. doi:10.1155/2020/8392542
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