ABSTRACT
Purpura is defined as extravasation of red blood cells resulting in discoloration of the skin or mucous membranes secondary to any disturbance of the normal physiological mechanisms that normally prevent blood from escaping from the vessels, or from damage or lack of support to the vasculature. It is an important and easily recognizable sign and can occur isolated or as part of a systemic disorder. The causes of purpura range from trivial (actinic/senile purpura) to extremely alarming and life-threatening conditions (vasculitis) that need to be diagnosed and treated early. The most common causes of purpura are due to platelet and coagulation disorders. An easy clinical differentiation from intravascular causes of erythema can be made by diascopy where purpura do not show any blanching on being pressed by a slide, which is present in cases of erythema. Management of purpura is generally multidisciplinary involving the dermatologist, hematologist, rheumatologist, nephrologist, and other relevant specialists for life-threatening causes. Purpura is an important cutaneous clinical sign with myriad of causes ranging from trivial to life-threatening disorders. Prompt identification of this sign and approaching the patient based on thorough history and clinical examination can be significant as early diagnosis and treatment initiation can save the life of the patient in cases with purpura secondary to causes with significant mortality.
